Exploring literature on knowledge, attitudes, beliefs and practices towards urinary incontinence management: a scoping review.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence affects women of all ages, influencing 8.5% of the world's population in 2018. Effective management of urinary incontinence is influenced by patients help-seeking behaviour and services offered by healthcare professionals within the healthcare system. To facilitate behavioural change, it is important to understand the knowledge(Knowledge: "the comprehension and understanding of acquired facts or information about UI in adults"), attitudes (Attitude: "a predisposed perspective which influences nurses' thoughts, feelings, perceptions and behaviours towards care of adults with UI") and beliefs (Beliefs: "a theoretically conceptualized conviction or expectation regarding UI in general") of healthcare practitioners towards urinary incontinence management. The aim of this review is thus to systematically map the existing literature, reporting on how knowledge, attitude, belief and practices towards urinary incontinence management have been explored. METHODS: Six databases were systematically searched. Included studies were published between January 2013 to January 2020 in English, investigating urinary incontinence management in women. RESULTS: The search yielded 39 studies, with data emanating from 16 counties. Quantitative, Qualitative and mixed methodologies were used to explore the four concepts of knowledge, attitudes, beliefs and practices. A wide range of healthcare practitioners were questioned and management was explored in five healthcare settings. All factors explored related to the four concepts are reported and factors reaching consensus in included literature were highlighted. CONCLUSION: The summarized factors can assist further investigations into the four concepts to change healthcare practitioner's behaviour towards urinary incontinence management.

Cystic fibrosis in South Africa: A changing diagnostic paradigm.

Cystic fibrosis (CF), one of the most commonly observed and diagnosed fatal monogenic disorders globally, was initially thought to affect individuals of Caucasian/European descent almost exclusively. It is increasingly appreciated, however, that non-Caucasian populations are also affected by this condition. Although this has been known in South Africa (SA) for over two decades, a large disparity still exists in data pertaining to the different population groups in the country. This article seeks to highlight existing published data on CF in SA populations and reflects on the means through which these have been generated over the years. Additionally, the article briefly discusses the consequences of incomplete data and how this could potentially be addressed in the future through innovative and collaborative approaches.

Foundation for an evidence-informed algorithm for treating pelvic floor mesh complications: a review.

To address evidence gaps on the management of complications related to mesh in pelvic floor surgery, we created an evidence-based algorithm that includes defining evidence gaps. We utilized the Delphi method within a panel of surgeons treating mesh complications to define a treatment strategy. The first round provided a list of clinically based postulates that informed a review expanding postulates to recommendations and included grading of the quality of evidence. A second round informed the final algorithm. While the quality of the available evidence is low, it provides a framework for planning diagnosis and management of mesh-related complications. TWEETABLE ABSTRACT: Removal of mesh must balance resolution of complications with the risk of removal and recurrence of pelvic floor symptoms.

Transient clinical improvement of a mitochondrial neurogastrointestinal encephalomyopathy-like syndrome after allogeneic haematopoietic stem cell transplantation.

Mitochondrial neurogastrointestinal encephalopathy (MNGIE), usually an autosomal-recessive inherited condition, causes gastrointestinal dysmotility, ophthalmoplegia, ptosis, leukoencephalopathy and neuropathy. The chromosome 22 disorder, due to mutations in the nuclear gene TYMP encoding thymidine phosphorylase (TP), leads to the accumulation of thymidine and deoxyuridine, with mitochondrial dysfunction.This report describes a patient with an MNGIE-like syndrome with a heterozygous TYMP mutation who showed marked, but transient improvement postallogeneic haematopoietic stem cell transplantation (HSCT).The patient, showing ptosis and ophthalmoplegia, was initially managed for myasthenia gravis. She developed gastrointestinal symptoms, dysarthria, dysphagia and weakness, and MNGIE was considered due to its low TP levels and improvement after platelet transfusions. She underwent HSCT, with dramatic improvement, but regressed 18 months later despite normal TP levels, platelet counts and full chimerism.MNGIE may encompass a spectrum of disorders. TP deficiency alone is unlikely to explain all clinical signs, and other factors, including the possible development of anti-TP antibodies, which may play a role in the pathophysiology.

Fibre-reinforced composite (FRC) bridge--a minimally destructive approach.

Replacing missing teeth is an integral part of the clinical services of the dental practitioner. The fibre-reinforced composite (FRC) bridge is a relatively new method for replacing missing teeth. This article will explain and discuss this alternative treatment option. Practical instructions on how to construct a FRC bridge will be given, by means of a clinical case. Different technique options will be illustrated to provide the reader with a good understanding of the most practical way to use the FRC strips. The fibre-reinforced composite provides a non-destructive, aesthetically pleasing and cost-effective way to restore missing teeth. Clinical Relevance: Minimally invasive options should always be considered and destruction of healthy enamel and dentine during the preparation phase of a replacement treatment should be avoided as much as possible.

Relationship between human spermatozoa-hyaluronan-binding assay, conventional semen parameters and fertilisation rates in intracytoplasmic spermatozoa injection.

Selecting the best spermatozoa for intracytoplasmic spermatozoa injection (ICSI) has recently been a topic of great interest among embryologists. The study aimed to evaluate the relationship between the spermatozoa-hyaluronan-binding assay (HBA), routine semen analysis results and fertilisation rates as recorded during conventional ICSI therapy. Ninety-one patients undergoing conventional ICSI treatment in the Medfem Fertility Clinic in Johannesburg (South Africa) were included in the study. A total of 797 oocytes were injected of which 457 oocytes fertilised (57.3%, range 0-100%). None of the semen parameters correlated with the fertilisation rates (Table 2). HBA scores, however, revealed a highly significant association (p ≤ 0.0001) with the fertilisation rates. The HBA scores also correlated significantly with the biochemical pregnancy values (Spearman r = 0.24, P = 0.02, 95% CI 0.039-0.43); however, the HBA scores did not correlate with the clinical pregnancy rates (Spearman r = 0.14, P = 0.16, 95% CI -0.06 to 0.34). No correlation was recorded between HBA and the standard semen parameters. The study showed that HBA is significantly associated with fertilisation in conventional ICSI. The HBA scores were also significantly associated with the fertilisation rates and biochemical pregnancies.

cis-{2,6-Bis[(di-tert-butyl-phosphan-yl)meth-yl]cyclo-hexyl-κ(3) P,C (1),P'}chloridopalladium(II).

The Pd(II) atom in the title compound, [Pd(C24H49P2)Cl], has a distorted square-planar CClP2 coordination geometry with the P,C,P'-tridentate ligand forming two five-membered metallacycles. The cyclo-hexane ring is aligned with the Pd(II) coordination plane due to C-H activation in an equatorial position, giving a tri-equatorial conformation of the cyclo-hexyl ring.

Primary sclerosing cholangitis, Crohn's disease and HLA-B27 in black South African women.

Crohn's disease is rare in South African black people and primary sclerosing cholangitis (PSC) is also rare in black patients with IBD, from South Africa. The presence of HLA-B27 is generally associated with seronegative spondylo-arthropathies and correlates with the occurrence of ankylosing spondylitis, recurrent mouth ulcers and uveitis, in patients with IBD. We describe two women with the combination of Crohn's disease, PSC and HLA-B27 from our cohort of the last 5 years of three black patients with Crohn's disease. Crohn's disease, PSC and HLA-B27 respectively, occur rarely in black South Africans and their concurrent presence in two black women suggests a pathogenetic link of HLA-B27 between Crohn's disease and PSC in this population. Female gender might be an additional determinant in this setting.

Effects of Bt maize on Agrotis segetum (Lepidoptera: Noctuidae): a pest of maize seedlings.

The lepidopteran stemborers Busseola fusca (Fuller) (Lepidoptera: Noctuidae), Sesamia calamistis (Hampson) (Lepidoptera: Noctuidae), and Chilo partellus (Swinhoe) (Lepidoptera: Crambidae) are effectively controlled by Bt maize that expresses the Cry1Ab insecticidal protein. Another noctuid species, the cutworm Agrotis segetum (Denis and Schiffermüller) (Lepidoptera: Noctuidae), which is the most common and injurious pest of maize seedlings in South Africa, is exposed to Bt toxin for a part of its life cycle. The effect of this exposure to Bt maize has not been studied yet. The aims of this study were to determine the effects of Bt maize (events MON810 and Bt11) on larval mass, development time, survival, and fecundity of A. segetum. Laboratory studies were conducted with first- and fourth-instar larvae and moths. Results showed that the effect of Cry1Ab toxin on the biology of A. segetum larvae and moths were largely insignificant. The effects of the two Bt maize events on the different parameters measured in this study was not similar between the Bt events and their respective iso-hybrids. Compared with larvae that fed on conventional (non-Bt) maize, Bt maize did not affect survival of first-instar larvae. However, mean mass of larvae that fed on Bt maize (Bt11) was significantly lower. Feeding on Bt maize did not have a significant effect on development and survival of fourth-instar larvae or moth longevity. It did, however, delay the development period to pupa formation. Fewer eggs were laid by moths fed as larvae on maize event Bt11 compared with MON810. This study indicates that Bt maize will most likely not have any significant effect on the control of A. segetum under field conditions.

The imaging of stab injuries.

In the trauma unit of the Bloemfontein Academic Complex, the total number of stab wounds seen represents approximately 70.5% of penetrating injuries, which is 6.4% of 5004 trauma cases seen in a period of 1 year. The other cases are gunshot wounds and pedestrian or motor vehicle accidents. Specific guidelines and protocols are followed for penetrating trauma management. All imaging modalities are utilized, with chest radiography the mainstay of thoracic imaging in patients having sustained sharp penetrating chest injuries. Computed tomography (CT) is being used more frequently as the primary imaging modality in the evaluation of hemodynamically stable patients with penetrating injuries. The improved speed of data acquisition and superior image reconstruction of multidetector CT (MDCT) has further driven this change in imaging approach. Although digital subtraction angiography (DSA) has been the reference standard for the diagnosis of traumatic vascular injuries, it is giving way to faster, less invasive, and less personnel-intensive imaging techniques, e.g., MDCT angiography. Given the fact that we work in an academic environment and that we have a dedicated interventional unit, arteriography is still frequently performed and still has its place as the "gold standard" in the diagnosis of vascular injuries. Penetrating chest injuries suspected of traversing the mediastinum or extending near the posterior mediastinal structures dictate esophageal and tracheal evaluation. Although radiology has a role to play, direct visualization (esophagoscopy, bronchoscopy) remains the most reliable method of excluding injuries to these structures. Transthoracic ultrasound (echocardiography) has become indispensable in helping to evaluate injuries to the heart and the ascending and descending aortas. More recent work has demonstrated that ultrasonography can also be used to detect hemothoraces and pneumothoraces with accuracy.

Racemic tricarbon-yl(η-7-meth-oxy-flavan)chromium(0).

IN THE TITLE COMPOUND [SYSTEMATIC NAME: tricarbonyl(η(6)-7-methoxy-2-phenyl-3,4-dihydro-2H-1-benzopyran)chromium(0)], [Cr(C(16)H(16)O(2))(CO)(3)], the Cr(CO)(3) unit is coordinated by the phenyl-ene ring of the flavan ligand, exhibiting a three-legged piano-stool conformation, with a point to plane distance of 1.750 (1) Å. The phenyl ring is twisted away from the fused ring system by 36.49 (5)° (r.m.s. deviation = 0.027 Å; fitted atoms are the C(6) ring and the attached fused-ring C and O atoms). The dihydro-pyran ring displays a distorted envelope configuration by displacement of the phenyl-bearing and the adjacent ring C atoms from the fused-ring system plane by 0.356 (2) and 0.402 (2) Å, respectively.

Racemic tricarbonyl[(4a,5,6,7,8,8a-η)-2-phenyl-3,4-dihydro-2H-1-benzopyran]chromium(0).

The title compound, [Cr(C(15)H(14)O)(CO)(3)], displays a distorted envelope configuration of the dihydro-pyrane ring. The dihedral angle between the phenyl and phenyl-ene rings is 50.63 (4)°. The Cr(0) atom is coordinated by three CO groups and the phenyl-ene ring of the flavan ligand in an η(6) mode, with a common arene-to-metal distance.

Management of life-threatening haemoptysis in an area of high tuberculosis incidence.

BACKGROUND: Emergency admissions with life-threatening haemoptysis in an area of high tuberculosis (TB) incidence at the University of Stellenbosch and Tygerberg Academic Hospital, South Africa. It is unclear if lung resection is regularly indicated to prevent recurrence following bronchial artery embolisation (BAE). OBJECTIVE: To prospectively evaluate risk factors for recurrence as selection criteria for surgery following embolisation: lack of complete cessation of haemoptysis, need for blood transfusion, presence of aspergilloma and absence of active TB. DESIGN: Prospective interventional study with 1-year follow-up. RESULTS: Within a 7-month period, 101 consecutive patients were admitted. Seven were excluded and 12 died shortly after admission. Haemoptysis ceased on medical treatment alone within 24 h in 21 of the remaining 82 patients. Their 1-year mortality was 10%. Eleven of 61 patients referred for emergency embolisation died before discharge. Of the 50 patients remaining at risk of recurrence, 38 (76%) were at low risk and 12 (24%) at high risk. Five of these patients (10% of those at risk) underwent surgery. Patients at low risk and operated patients had an uneventful course over 1 year, but two deaths occurred among the seven inoperable patients at high risk. CONCLUSION: Lung resection surgery following successful BAE for life-threatening haemoptysis can safely be avoided in patients at low risk of recurrence.

Field-evolved insect resistance to Bt crops: definition, theory, and data.

Transgenic crops producing Bacillus thuringiensis (Bt) toxins for insect pest control have been successful, but their efficacy is reduced when pests evolve resistance. Here we review the definition of field-evolved resistance, the relationship between resistance and field control problems, the theory underlying strategies for delaying resistance, and resistance monitoring methods. We also analyze resistance monitoring data from five continents reported in 41 studies that evaluate responses of field populations of 11 lepidopteran pests to four Bt toxins produced by Bt corn and cotton. After more than a decade since initial commercialization of Bt crops, most target pest populations remain susceptible, whereas field-evolved resistance has been documented in some populations of three noctuid moth species: Spodoptera frugiperda (J. E. Smith) to Cry1F in Bt corn in Puerto Rico, Busseola fusca (Fuller) to CrylAb in Bt corn in South Africa, and Helicoverpa zea (Boddie) to CrylAc and Cry2Ab in Bt cotton in the southeastern United States. Field outcomes are consistent with predictions from theory, suggesting that factors delaying resistance include recessive inheritance of resistance, abundant refuges of non-Bt host plants, and two-toxin Bt crops deployed separately from one-toxin Bt crops. The insights gained from systematic analyses of resistance monitoring data may help to enhance the durability of transgenic insecticidal crops. We recommend continued use of the longstanding definition of resistance cited here and encourage discussions about which regulatory actions, if any, should be triggered by specific data on the magnitude, distribution, and impact of field-evolved resistance.

Tricarbon-yl(η-4',7-dimethoxy-iso-flavone)chromium(0).

The metal atom of the Cr(CO)(3) unit of the title compound, [Cr(C(17)H(14)O(4))(CO)(3)], is coordinated to the methoxy-phenyl ring of the isoflavone ligand; the Cr(CO)(3) unit exhibits a three-legged piano-stool conformation. The aromatic ring of the methoxy-phenyl group is twisted by 42.49 (9)° with respect to the γ-pyrone ring. In the fused-ring, the dihedral angle between the phenyl-ene and γ-pyrone rings is 3.08 (13)°.

Tricarbon-yl(η-flavone)chromium(0).

In the title compound, [Cr(C(15)H(10)O(2))(CO)(3)], the Cr(CO)(3) unit exhibits a three-legged piano-stool conformation. The chromium metal centre is coordinated by the phenyl ring of the flavone ligand [Cr-(phenyl centroid) distance = 1.709 (1) Å]. The ligand is approximately planar, the dihedral angles between the γ-pyrone ring and the phenyl ring and between the γ-pyrone and the phenyl-ene ring being 2.91 (5) and 3.90 (5)°, respectively. The mol-ecular packing shows π-π stacking between the flavone ligands of neighbouring mol-ecules.

cis-trans isomers of PtX4L2 (X = halogen and L = neutral ligand): trans-bis(dimethyl sulfide)tetraiodidoplatinum(IV).

The octahedral title complex, [PtI4(C2H6S)2] or trans-PtI4(dms)2 (dms is dimethyl sulfide), crystallizes in the monoclinic space group P2(1)/n (Z = 2), with molecular symmetry C(i), which is the most frequently occurring point group for trans-PtX4L2 {56%, 28 structures in the Cambridge Structural Database (CSD) [Allen (2002). Acta Cryst. B58, 380-388]}, followed by C(1) (22%, 11 structures). The complexes form a puckered pseudo-hexagonal layer in the (10(1)) plane, and the layers are stacked with an interplanar distance of 7.10 A. Density functional theory (DFT) calculations on an isolated complex with the observed parameters as a starting structure converged to C(2h). Constraints to C(i) on the observed geometry give 3-4 kJ mol(-1) higher energy compared with C(2h). DFT calculations on [PtCl4(PzH)2] (PzH is pyrazole), reported in the CSD in both the cis and trans forms, show an energy difference of 21 kJ mol(-1) in favour of the trans complex. A CSD search for PtX4L2-type complexes, where X is a halogen and L is a ligand with a donor atom from group 14, 15 or 16, indicated a preferred trans geometrical arrangement, with a total fraction of 68%. The dominating crystal packing operators for the trans complexes are an inversion centre combined with a screw axis/glide plane (48%), followed by an inversion centre alone (28%).

Tetra-kis(µ-2-methyl-benzoato)bis-[(2-methyl-benzoic acid)copper(II)].

In the title centrosymmetric dinuclear compound, [Cu(2)(C(8)H(7)O(2))(4)(C(8)H(8)O(2))(2)], four o-toluate anions form a cage around two Cu atoms in a syn-syn configuration. Two more o-toluic acid mol-ecules are apically bonded to the Cu atoms, which show a square-pyramidal coordination geometry. The acid H atoms are hydrogen bonded to the cage carboxyl O atoms [O⋯O = 2.660 (2) Å]. The mol-ecular packing forms a puckered pseudo-hexa-gonal close-packed layer in the (h00) plane, with soft inter-molecular H⋯H contacts (2.46-2.58 Å).