Overactive Bladder Symptoms in Female Health Profession Students: Bladder Diary Characteristics and Impact of Symptoms on Health-Related Quality of Life.

INTRODUCTION: There is limited information on overactive bladder (OAB) symptoms, their association with bladder irritants, or the effect of OAB on health-related quality of life (HRQoL) in young women. We evaluated these issues in a group of young female health profession students. METHODS: All female students (n = 964) attending a university in the Pacific Northwest were recruited via email or an in-person informational meeting to participate in this descriptive cross-sectional study. Outcome measures included the OAB-questionnaire, a 4-day bladder diary, and a demographic questionnaire. OAB was diagnosed if a participant reported an average of at least one episode of urgency per day on the bladder diary. Participant characteristics, bladder diary results, and HRQoL were compared using chi square, Fisher's exact test, and t-tests. RESULTS: With a response rate of 21.2%, the average participant age was 25.5 years and 21.7% of participants were identified as having OAB. Participants with OAB consumed more caffeine (mean [standard deviation [SD] 2.0 [1.5] vs. 1.5 [1.2], p = 0.016), more carbonated beverages (mean [SD] 0.5 [0.6] vs. 0.3 [0.5], p = 0.047), more total units of bladder irritants (mean [SD] 3.1 [2.0] vs. 2.1 [1.6], p = 0.002), and had significantly worse HRQoL (p = 0.001) than those without OAB. No differences were found for other parameters measured. CONCLUSION: Participants with OAB consumed more bladder irritants than participants without OAB. Future research should address larger groups of young women from different backgrounds, as well as other factors or characteristics that could be associated with OAB.

OASIS inter-rater reliability and reimbursement: a study of inter-rater reliability of the Outcome and Assessment Information Set (OASIS): its effects on the Home Health Resource Group (HHRG) and reimbursement.

One of the outcomes of the initial Outcome and Assessment Information Set (OASIS) is to establish a level of reimbursement through the Medicare Prospective Payment System (PPS). Several inter-rater reliability (IRR) studies have noted differences in responses to individual questions within the OASIS but little is known about how variations in scoring might affect the final reimbursement projection. In a one-way repeated measures design study, the OASIS was completed on 52 patients by both an RN and a PT within a 24-hour timeframe and the projected reimbursement rates were compared. Fifty-four percent of the outcomes of the assessment pairs were identical; differences in the remaining 46% were equally divided between RNs and PTs in projecting a higher reimbursement rate and with similar distributions. The mean difference in projected reimbursement rates was $16.43 per episode with no significant difference between the PT and RN Home Health Resource Group (HHRG) distributions.

Does fear of falling influence spatial and temporal gait parameters in elderly persons beyond changes associated with normal aging?

BACKGROUND: Limited research exists on fear of falling and its affect on gait parameters. Studies have shown a relationship between fear of falling and restriction of activities. The purpose of this study was to determine if a fear of falling in elderly persons was associated with changes in spatial and temporal gait parameters, independent of a history of falls. It was hypothesized that, in elderly persons, gait changes would be associated with a preexisting fear of falling. METHODS: Ninety-five community-dwelling adults, aged 60-97 years (mean age = 74, standard deviation = 8.5) participated in this study. Participant scores on the Modified Falls Efficacy Scale determined an individual's placement into the "fearful" or "fearless" category. Spatial and temporal gait parameters of speed, stride length, step width, and double limb support time were assessed using the GAITRite system, a computerized electronic walkway. RESULTS: The fearful group had a significantly slower gait speed (p <.05) and shorter stride length (p <.05) when compared to the fearless group. Stride width was significantly longer (p =.05) and double limb support time was significantly prolonged (p <.05) in the fearful participants when measured against the fearless participants. CONCLUSIONS: The results of this study support the hypothesis that fear of falling does influence spatial and temporal gait parameter changes in elderly persons. Slower gait speed, shorter stride length, increased stride width, and prolonged double limb support time were found to be associated with a preexisting fear of falling.