scholarly journals Management of Long-Segment and Panurethral Stricture Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Francisco E. Martins ◽  
Sanjay B. Kulkarni ◽  
Pankaj Joshi ◽  
Jonathan Warner ◽  
Natalia Martins
Keyword(s):  
Geographic Location ◽  
Lichen Sclerosus ◽  
Treatment Modalities ◽  
Invasive Technique ◽  
Industrialized Countries ◽  
Urethral Catheterization ◽  
Anterior Urethra ◽  
The Individual ◽  
Urethral Surgery

Long-segment urethral stricture or panurethral stricture disease, involving the different anatomic segments of anterior urethra, is a relatively less common lesion of the anterior urethra compared to bulbar stricture. However, it is a particularly difficult surgical challenge for the reconstructive urologist. The etiology varies according to age and geographic location, lichen sclerosus being the most prevalent in some regions of the globe. Other common and significant causes are previous endoscopic urethral manipulations (urethral catheterization, cystourethroscopy, and transurethral resection), previous urethral surgery, trauma, inflammation, and idiopathic. The iatrogenic causes are the most predominant in the Western or industrialized countries, and lichen sclerosus is the most common in India. Several surgical procedures and their modifications, including those performed in one or more stages and with the use of adjunct tissue transfer maneuvers, have been developed and used worldwide, with varying long-term success. A one-stage, minimally invasive technique approached through a single perineal incision has gained widespread popularity for its effectiveness and reproducibility. Nonetheless, for a successful result, the reconstructive urologist should be experienced and familiar with the different treatment modalities currently available and select the best procedure for the individual patient.

scholarly journals Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management

Medicina ◽  
2010 ◽  
Vol 46 (11) ◽  
pp. 790 ◽  
Author(s):  
Giedrė Sakalauskienė ◽  
Dovilė Jauniškienė
Keyword(s):  
Treatment Modalities ◽  
Treatment Programs ◽  
Health Providers ◽  
Effective Interventions ◽  
Lack Of Information ◽  
Appropriate Treatment ◽  
Short And Long Term ◽  
The Individual

Etiology, epidemiology, and impact of osteoarthritis on an individual, society, and nation and the main principles of management of this disease are reviewed in the article. Treatment should be tailored to the needs of an individual patient. Physicians should be familiar with pharmacologic and nonpharmacologic treatment modalities to maximize effective utilization and a thorough understanding of short- and long-term complications and costs. Severity of osteoarthritis should be taken into physician’s and patient’s consideration while applying an appropriate treatment. A stepwise management of osteoarthritis has to be taken into account. As effective interventions remain underused, state arthritis programs, including osteoarthritis programs, have to be developed to build an appropriate scientific base in public health, observe burden and impact, assess and disseminate evidence-based interventions, and work to reduce and delay disability, and improve quality of life among people with arthritis. Adequate studies on the costs of osteoarthritis are urgently required so that cogent arguments can be made to governments to appropriately fund prevention and treatment programs for this condition. Its recognition as a major cause of disability, particularly in the aging population, should increase community focus on this important condition. Osteoarthritis as a pathogenic process and its impact on an individual and society should be taken into special consideration by health providers and officers developing the national health policy in Lithuania, because there is a lack of information related to the prevalence of osteoarthritis, risk factors, also osteoarthritisassociated disability, and costs of the management of this disease among Lithuanian inhabitants.

scholarly journals Schema therapy for violent PD offenders: a randomized clinical trial

2021 ◽  
pp. 1-15
Author(s):  
David P. Bernstein ◽  
Marije Keulen-de Vos ◽  
Maartje Clercx ◽  
Vivienne de Vogel ◽  
Gertruda C. M. Kersten ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Treatment Time ◽  
Treatment Modalities ◽  
Schema Therapy ◽  
Treatment As Usual ◽  
Multiple Treatment ◽  
Violent Criminal ◽  
The Individual

Abstract Background Violent criminal offenders with personality disorders (PD's) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise-specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*time: t(1387) = −2.85, p = 0.005). Conclusions These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community.

Knowledge translation strategies for mobilizing organizations to implement pain evidence to practice

2021 ◽  
pp. 627-637
Author(s):  
Bonnie J. Stevens ◽  
Stefan J. Friedrichsdorf ◽  
Alison Twycross
Keyword(s):  
Knowledge Translation ◽  
Treatment Modalities ◽  
Care Providers ◽  
Effective Prevention ◽  
Translation Strategies ◽  
Healthy Development ◽  
Knowledge Translation Strategies ◽  
New Knowledge ◽  
The Individual

Understanding how to prevent, treat, or minimize pain in children is critical for their future healthy development. The focus of research has been to generate new knowledge on pain in the developing nervous system and to determine effective prevention and treatment modalities. However, evidence generated from research is often not effectively implemented by professional and lay care providers, policymakers, and others. To enhance our collective efforts to protect children from the immediate and long-term consequences of pain, we need to determine effective knowledge translation (KT) strategies targeted at the individual, organization, or society. Inconsistent use of terminology is common. Therefore, we will use the term KT to refer to the more general iterative process for shaping and tailoring of evidence for the targeted knowledge user, whilst implementation is the process used to integrate (promote the uptake of new knowledge) and communicate new knowledge with the goal of changing behavior, and dissemination refers to the spread and mobilization of knowledge. KT that involves organizations and systems is the focus of this chapter.

Herbal Medicine for Glioblastoma: Current and Future Prospects

2020 ◽  
Vol 16 (8) ◽  
pp. 1022-1043
Author(s):  
Imran Khan ◽  
Sadaf Mahfooz ◽  
Mustafa A. Hatiboglu
Keyword(s):  
Cell Proliferation ◽  
Survival Rates ◽  
Standard Of Care ◽  
Natural Compounds ◽  
Treatment Modalities ◽  
Normal Brain ◽  
The Central Nervous System ◽  
Cycle Regulation ◽  
Immense Potential

Background: Glioblastoma is one of the most aggressive and devastating tumours of the central nervous system with short survival time. Glioblastoma usually shows fast cell proliferation and invasion of normal brain tissue causing poor prognosis. The present standard of care in patients with glioblastoma includes surgery followed by radiotherapy and temozolomide (TMZ) based chemotherapy. Unfortunately, these approaches are not sufficient to lead a favorable prognosis and survival rates. As the current approaches do not provide a long-term benefit in those patients, new alternative treatments including natural compounds, have drawn attention. Due to their natural origin, they are associated with minimum cellular toxicity towards normal cells and it has become one of the most attractive approaches to treat tumours by natural compounds or phytochemicals. Objective: In the present review, the role of natural compounds or phytochemicals in the treatment of glioblastoma describing their efficacy on various aspects of glioblastoma pathophysiology such as cell proliferation, apoptosis, cell cycle regulation, cellular signaling pathways, chemoresistance and their role in combinatorial therapeutic approaches was described. Methods: Peer-reviewed literature was extracted using Pubmed, EMBASE Ovid and Google Scholar to be reviewed in the present article. Conclusion: Preclinical data available in the literature suggest that phytochemicals hold immense potential to be translated into treatment modalities. However, further clinical studies with conclusive results are required to implement phytochemicals in treatment modalities.

The Acceptance of Party Unity in Parliamentary Democracies

2017 ◽  
Author(s):  
David M. Willumsen
Keyword(s):  
Political Parties ◽  
Costs And Benefits ◽  
Parliamentary Democracies ◽  
Survey Questions ◽  
Ideal Policy ◽  
Central Argument ◽  
The Individual ◽  
Policy Incentives

The central argument of this book is that voting unity in European legislatures is not primarily the result of the ‘disciplining’ power of the leadership of parliamentary parties, but rather the result of a combination of ideological homogeneity through self-selection into political parties and the calculations of individual legislators about their own long-term benefits. Despite the central role of policy preferences in the subsequent behaviour of legislators, preferences at the level of the individual legislator have been almost entirely neglected in the study of parliaments and legislative behaviour. The book measures these using an until now under-utilized resource: parliamentary surveys. Building on these, the book develops measures of policy incentives of legislators to dissent from their parliamentary parties, and show that preference similarity amongst legislators explains a very substantial proportion of party unity, yet alone cannot explain all of it. Analysing the attitudes of legislators to the demands of party unity, and what drives these attitudes, the book argues that what explains the observed unity (beyond what preference similarity would explain) is the conscious acceptance by MPs that the long-term benefits of belonging to a united party (such as increased influence on legislation, lower transaction costs, and better chances of gaining office) outweigh the short-terms benefits of always voting for their ideal policy outcome. The book buttresses this argument through the analysis of both open-ended survey questions as well as survey questions on the costs and benefits of belonging to a political party in a legislature.

scholarly journals Human beta defensin levels and vaginal microbiome composition in post-menopausal women diagnosed with lichen sclerosus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandra Brunner ◽  
Márta Medvecz ◽  
Nóra Makra ◽  
Miklós Sárdy ◽  
Kinga Komka ◽  
...  
Keyword(s):  
Lichen Sclerosus ◽  
Gardnerella Vaginalis ◽  
Control Group ◽  
Vaginal Microbiome ◽  
Microbiome Composition ◽  
Streptococcus Anginosus ◽  
Menopausal Women ◽  
Post Menopausal ◽  
The Individual ◽  
Level Production

AbstractHuman beta defensins (hBDs) may play an important role in the progression of lichen sclerosus (LS), due to their ability to induce excessive stimulation of extracellular matrix synthesis and fibroblast activation. The genetic ability of the individual to produce defensins, the presence of microbes influencing defensin production, and the sensitivity of microbes to defensins together regulate the formation of an ever-changing balance between defensin levels and microbiome composition. We investigated the potential differences in postmenopausal vaginal microbiome composition and vaginal hBD levels in LS patients compared to non-LS controls. LS patients exhibited significantly lower levels of hBD1 (p = 0.0003), and significantly higher levels of hBD2 (p = 0.0359) and hBD3 (p = 0.0002), compared to the control group. The microbiome of the LS patients was dominated by possibly harmful bacteria including Lactobacillus iners, Streptococcus anginosus or Gardnerella vaginalis known to initiate direct or indirect damage by increasing defensin level production. Our observations highlight that correcting the composition of the microbiome may be applicable in supplementary LS therapy by targeting the restoration of the beneficial flora that does not increase hBD2-3 production.

scholarly journals Title I: Modernizing Definitions and Programs Under the Administration on Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 714-715
Author(s):  
Marie Gualtieri
Keyword(s):  
Title I ◽  
Adult Population ◽  
Term Care ◽  
Older Americans ◽  
Aging Society ◽  
Program Adaptation ◽  
Older Americans Act ◽  
The Individual ◽  
Older Adult Population

Abstract The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.

scholarly journals Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury

2020 ◽  
pp. 030802262097951
Author(s):  
Lizette Norin ◽  
Björn Slaug ◽  
Maria Haak ◽  
Susanne Iwarsson
Keyword(s):  
Older Adults ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Occupational Performance ◽  
Environmental Barriers ◽  
Cord Injury ◽  
Long Term Follow Up ◽  
Societal Level ◽  
The Individual

Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.

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