University of Aberdeen

About: University of Aberdeen is a education organization based out in Aberdeen, United Kingdom. It is known for research contribution in the topics: Population & Health care. The organization has 21174 authors who have published 49962 publications receiving 2105479 citations. The organization is also known as: Aberdeen University.

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women

Abstract: Background About a third of women have urinary incontinence and up to a 10th have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence. Objectives To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence. Search methods We searched the Cochrane Incontinence Group Specialised Register, which includes searches of CENTRAL, MEDLINE, MEDLINE in Process and handsearching (searched 7 February 2012) and the references of relevant articles. Selection criteria Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trial needed to include pelvic floor muscle training (PFMT). Another arm was either no PFMT or usual antenatal or postnatal care. Data collection and analysis Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. Three different populations of women were considered separately, women dry at randomisation (prevention); women wet at randomisation (treatment); and a mixed population of women who might be one or the other (prevention or treatment). Trials were further divided into those which started during pregnancy (antenatal); and those started after delivery (postnatal). Main results Twenty-two trials involving 8485 women (4231 PFMT, 4254 controls) met the inclusion criteria and contributed to the analysis. Pregnant women without prior urinary incontinence (prevention) who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence up to six months after delivery (about 30% less; risk ratio (RR) 0.71, 95% CI 0.54 to 0.95, combined result of 5 trials). Postnatal women with persistent urinary incontinence (treatment) three months after delivery and who received PFMT were less likely than women who did not receive treatment or received usual postnatal care to report urinary incontinence 12 months after delivery (about 40% less; RR 0.60, 95% CI 0.35 to 1.03, combined result of 3 trials). It seemed that the more intensive the programme the greater the treatment effect. The results of seven studies showed a statistically significant result favouring PFMT in a mixed population (women with and without incontinence symptoms) in late pregnancy (RR 0.74, 95% CI 0.58 to 0.94, random-effects model). Based on the trial data to date, the extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear (that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not). It is possible that mixed prevention and treatment approaches might be effective when the intervention is intensive enough. There was little evidence about long-term effects for either urinary or faecal incontinence. Authors' conclusions There is some evidence that for women having their first baby, PFMT can prevent urinary incontinence up to six months after delivery. There is support for the widespread recommendation that PFMT is an appropriate treatment for women with persistent postpartum urinary incontinence. It is possible that the effects of PFMT might be greater with targeted rather than mixed prevention and treatment approaches and in certain groups of women (for example primiparous women; women who had bladder neck hypermobility in early pregnancy, a large baby, or a forceps delivery). These and other uncertainties, particularly long-term effectiveness, require further testing.

Campylobacter Genotyping to Determine the Source of Human Infection

Abstract: Campylobacteriosis, caused principally by Campylobacter jejuni and Campylobacter coli, is among the main causes of bacterial gastroenteritis worldwide. In developing countries, campylobacteriosis is primarily a disease that occurs during infancy, because of high levels of early exposure and acquired immunity [1], but in industrialized countries, the epidemiology is characterized by sporadic infection throughout the population at all ages [2]. Campylobacter infection accounts for an estimated 2.5 million cases in the United States and >340,000 cases in the United Kingdom each year [3, 4], which is >3 times the number of cases caused by Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes combined [5]. The estimated annual economic burden of Campylobacter infection is £500 million in the United Kingdom [6] and $8 billion in the United States [7], but despite its significance as a public health problem, the relative contributions of different sources of infection to the human disease burden remain uncertain. Many species of wild and farm animals, particularly birds, carry Campylobacter species as part of their gut microbiota, and contamination of human food can occur at any point from the farm to the consumer. Potential sources of human infection include contaminated meat, poultry, water, and milk and contact with animals [8]. Analytical epidemiology methods, including risk assessment and case-control studies, provide some indirect evidence for the origin of disease, but because the majority of human Campylobacter infections are sporadic with very few recognized outbreaks that indicate a common infection source [9, 10], these approaches are incomplete. Because interventions for controlling Campylobacter transmission are costly and implementation requires consideration of cost-effectiveness, the uncertainty regarding the sources of human infection has inhibited effective public health intervention by government agencies and industry. Molecular typing has enhanced many epidemiological studies, including the identification of food-borne outbreaks of infection due to E. coli O157:H7 [11], Salmonella enterica [12], Campylobacter [13], and L. monocytogenes [14]; early identification of an outbreak source enables effective disease containment [14, 15]. Recent advances in bacterial genetic typing and analysis provide the opportunity to determine the origin of Campylobacter isolates obtained from patients on the basis of their genotypes, because there is sufficient genetic variation within the bacterial population to define host or source-associated genotypes [16]. In this study, we used multilocus sequence typing (MLST) [17], which has several advantages over other microbial typing schemes such as serotyping, PFGE, and flaA typing [18-20]. Because it is based on nucleotide sequence, MLST is inherently reproducible, scalable, and portable between laboratories, with data readily shared via the Internet [21]. We addressed the sources of campylobacteriosis in industrialized countries as part of the national Campylobacter MLST Project in Scotland (CaMPS), which included a comprehensive survey of isolates from all confirmed cases of human campylobacteriosis in Scotland during a 15-month period (from mid-July 2005 through mid-October 2006). To attribute isolates to a source, 4 important resources were exploited: (1) a standardized MLST genotyping protocol, (2) a national-scale contemporaneous comparison data set of MLST genotypes from potential disease sources in Scotland, (3) a substantial data archive of MLST genotypes from other sources and locations, and (4) model-based statistical methods that allow quantitative estimation of the genetic attribution of disease to source.

Anaesthetists' non-technical skills

Abstract: This review presents the background to the development of the anaesthetists' non-technical skills (ANTS) taxonomy and behaviour rating tool, which is the first non-technical skills framework specifically designed for anaesthetists. We share the experience of the anaesthetists who designed ANTS in relation to applying it in a department of anaesthesia, using it in a simulation centre, and the process of introducing it to the profession on a national basis. We also consider how ANTS is being applied in relation to training and research in other countries and finally, we discuss emerging issues in relation to the introduction of a non-technical skills approach in anaesthesia.

The Function of Fish Cytokines

Abstract: What is known about the biological activity of fish cytokines is reviewed. Most of the functional studies performed to date have been in teleost fish, and have focused on the induced effects of cytokine recombinant proteins, or have used loss- and gain-of-function experiments in zebrafish. Such studies begin to tell us about the role of these molecules in the regulation of fish immune responses and whether they are similar or divergent to the well-characterised functions of mammalian cytokines. This knowledge will aid our ability to determine and modulate the pathways leading to protective immunity, to improve fish health in aquaculture.