Airborne Influenza Virus in Daycare Centers.

In this study, we investigated the concentration of airborne influenza virus in daycare centers and influencing factors, such as common cold prevalence, air pollutants, and meteorological factors. A total of 209 air samples were collected from daycare centers in Kaohsiung and the influenza virus was analyzed using real-time quantitative polymerase chain reaction. Air pollutants and metrological factors were measured using real-time monitoring equipment. Winter had the highest positive rates of airborne influenza virus and the highest prevalence of the common cold, followed by summer and autumn. The concentration of CO was significantly positively correlated with airborne influenza virus. Daycare center A, with natural ventilation and air condition systems, had a higher concentration of airborne influenza A virus, airborne fungi, and airborne bacteria, as well as a higher prevalence of the common cold, than daycare center B, with a mechanical ventilation system and air purifiers, while the concentrations of CO2, CO, and UFPs in daycare center A were lower than those in daycare center B. We successfully detected airborne influenza virus in daycare centers, demonstrating that aerosol sampling for influenza can provide novel epidemiological insights and inform the management of influenza in daycare centers.

Diuresis Efficacy in Ambulatory Congested Heart Failure Patients: Intrapatient Comparison of 3 Diuretic Regimens (DEA-HF).

BACKGROUND: Limited evidence exists regarding efficacy and safety of diuretic regimens in ambulatory, congestion-refractory, chronic heart failure (CHF) patients. OBJECTIVES: The authors sought to compare the potency and safety of commonly used diuretic regimens in CHF patients. METHODS: A prospective, randomized, open-label, crossover study conducted in NYHA functional class II to IV CHF patients, treated in an ambulatory day-care unit. Each patient received 3 different diuretic regimens: intravenous (IV) furosemide 250 mg; IV furosemide 250 mg plus oral metolazone 5 mg; and IV furosemide 250 mg plus IV acetazolamide 500 mg. Treatments were administered once a week, in 1 of 6 randomized sequences. The primary endpoint was total sodium excretion, and the secondary was total urinary volume excreted, both measured for 6 hours post-treatment initiation. RESULTS: A total of 42 patients were recruited. Administration of furosemide plus metolazone resulted in the highest weight of sodium excreted, 4,691 mg (95% CI: 4,153-5,229 mg) compared with furosemide alone, 3,835 mg (95% CI: 3,279-4,392 mg; P = 0.015) and to furosemide plus acetazolamide 3,584 mg (95% CI: 3,020-4,148 mg; P = 0.001). Furosemide plus metolazone resulted in 1.84 L of urine (95% CI: 1.63-2.05 L), compared with 1.58 L (95% CI: 1.37-1.8); P = 0.039 collected following administration of furosemide plus acetazolamide and 1.71 L (95% CI: 1.49-1.93 L) following furosemide alone. The incidence of worsening renal function was significantly higher when adding metolazone (39%) to furosemide compared with furosemide alone (16%) and to furosemide plus acetazolamide (2.6%) (P < 0.001). CONCLUSIONS: In ambulatory CHF patients, furosemide plus metolazone resulted in a significantly higher natriuresis compared with IV furosemide alone or furosemide plus acetazolamide.

Salmonella Typhimurium caused an unprecedentedly large foodborne outbreak in Finland in 2021.

AIMS: Salmonella infections are significant causes of foodborne outbreaks in the European Union. This study investigates a sudden increase in gastroenteritis patients in the hospital district of Central Finland in June 2021. The primary aim was to study the outbreak's magnitude and source of the outbreak. METHODS AND RESULTS: Epidemiological, microbiological, environmental and traceback investigations were conducted. Over 700 persons fell ill during the outbreak caused by Salmonella Typhimurium associated with a daycare lunch. Similar S. Typhimurium was found in the patients and a vegetable mix containing iceberg lettuce, cucumber and peas served during lunch. The traceback investigation revealed that the batch information of vegetables from the wholesaler was not complete. The wholesaler had received quality complaints about the iceberg lettuce from the central kitchen. The manufacturer did not test the suspected batch for Salmonella since the production plant had given a certificate declaring it Salmonella negative. CONCLUSIONS: The most suspect ingredient was one batch of iceberg lettuce due to quality complaints. The lettuce had not been served in two daycare centres without cases. We recommend that in order to enable thorough microbiological investigation, institutional kitchens store the food samples separately as part of the internal quality control and that food items should always be tested when Salmonella contamination in an outbreak is suspected.

Revisiting the childcare-attachment question: under what conditions is childcare participation associated with mother-child attachment security?

Decades have passed since the controversy regarding the putative risks of childcare for mother-child attachment broke out. Yet, some uncertainty remains, as relevant studies have produced inconsistent evidence. Some have proposed that those conflicting findings may be due to the fact that the effects of childcare are conditioned on parenting. Accordingly, this study examined whether relations between childcare participation and mother-child attachment vary according to maternal sensitivity and autonomy support. In this sample of 236 mother-child dyads, there was no indication of main effects of childcare participation on attachment. There were, however, some interactive effects, such that the children who showed the least secure attachment behaviors were those who did not attend childcare and had either less sensitive or less autonomy-supportive mothers. The findings suggest that the effects of childcare on mother-child attachment are best understood in light of the parenting children receive at home.

SARS-CoV-2 Seroprevalence in a Berlin Kindergarten Environment: A Cross-Sectional Study, September 2021.

SARS-CoV-2 serology may be helpful to retrospectively understand infection dynamics in specific settings including kindergartens. We assessed SARS-CoV-2 seroprevalence in individuals connected to kindergartens in Berlin, Germany in September 2021. Children, staff, and household members from 12 randomly selected kindergartens were interviewed on COVID-19 history and sociodemographic parameters. Blood samples were collected on filter paper. SARS-CoV-2 anti-S and anti-N antibodies were assessed using Roche Elecsys. We assessed seroprevalence and the proportion of so far unrecognized SARS-CoV-2 infections. We included 277 participants, comprising 48 (17.3%) kindergarten children, 37 (13.4%) staff, and 192 (69.3%) household members. SARS-CoV-2 antibodies were present in 65.0%, and 52.7% of all participants were vaccinated. Evidence of previous infection was observed in 16.7% of kindergarten children, 16.2% of staff, and 10.4% of household members. Undiagnosed infections were observed in 12.5%, 5.4%, and 3.6%, respectively. Preceding infections were associated with facemask neglect. In conclusion, two-thirds of our cohort were SARS-CoV-2 seroreactive in September 2021, largely as a result of vaccination in adults. Kindergarten children showed the highest proportion of non-vaccine-induced seropositivity and an increased proportion of previously unrecognized SARS-CoV-2 infection. Silent infections in pre-school children need to be considered when interpreting SARS-CoV-2 infections in the kindergarten context.

Integrating technology into a successful apomorphine delivery program in Thailand: a 10-year journey of achievements with a five-motto concept.

Introduction: Apomorphine, a potent dopamine agonist, is a therapeutic option for patients with Parkinson's disease and motor fluctuations. However, the adoption of and adherence to this therapy have been limited by the need for complex delivery devices and specialized care as well as resource consumption, posing challenges for new physicians. Thailand is a unique example of a developing nation that has successfully implemented and continued the use of this therapy by employing cooperative technology that has dramatically enhanced apomorphine delivery services. Methods: Establishing apomorphine delivery services requires significant resources and step-by-step solutions. We began our services by implementing various strategies in three chronological stages: the initial stage (2013-2015), intermediate stage (2016-2019), and current stage (2020-present), each presenting unique challenges. Together, we also implemented a proposed set of five mottos to strengthen our apomorphine delivery service. Using additive technology, we developed a patient registry platform that combined electronic data acquisition, video and remote monitoring using wearable sensors, and in-house mobile applications to support our service. Results: At the initial stage, we assembled a team to enhance the efficacy and confirm the safety of apomorphine treatment in our hospital. At the intermediate stage, we expanded our apomorphine delivery services beyond just the patients at our hospital. We supported other hospitals in Thailand in setting up their own apomorphine services by educating both physicians and nurses regarding apomorphine therapy. With this educational undertaking, increased apomorphine-related knowledge among medical professionals, and a greater number of hospitals providing apomorphine services, an increasing number of patients were administered apomorphine in subsequent years. Currently, we are providing effective apomorphine delivery to improve patient outcomes and are seamlessly integrating technology into clinical practice. Incorporating integrative technologies in our apomorphine delivery program yielded positive results in data collection and support throughout patient care, in tracking patients' statuses, in the long-term use of this treatment, and in increasing medication adherence rates. Conclusion: This perspective paper describes how technology can help provide supportive healthcare services in resource-constrained environments, such as in Thailand, offering a step-by-step approach to overcoming several limitations. The valuable insights from our 10-year journey in successfully integrating technology into apomorphine delivery services can benefit new physicians seeking to replicate our success.

Care for Social Isolation and Loneliness in a Case With Late-Onset Delusional Disorder.

Late-onset psychosis refers to the development of psychotic symptoms after the age of 40 and can encompass various conditions like schizophrenia, mood disorders with psychotic features, and delusional disorder. Non-pharmacological interventions are critically important in older adults with psychosis, especially considering the lack of evidence for the efficacy of antipsychotics and the high risk of side effects. Social isolation is recognized as one of the risks of late-onset psychosis, and interventions to eliminate this risk are becoming increasingly important in Japan, where social isolation among older people is widespread as society ages. We present a case of late-onset delusional disorder in which multidimensional interventions for social isolation and loneliness, which have significant impacts on symptoms, were effective in achieving persistent remission. The case involved a woman in her mid-70s who began to complain of paranoia that taking a painkiller recommended by her husband caused persistent pain. Her husband's hospitalization and the deterioration of her relationship with her children resulted in her becoming socially isolated, which intensified her delusions and led to aggressive behavior and depression. Although antipsychotic medications had a limited effect, remission was achieved through supportive psychotherapy, cognitive therapy, family education, participation in group occupational therapy, and the introduction of daycare services, which were implemented to reduce loneliness and social isolation. Specifically, supportive psychotherapy and family education for her loneliness, awareness of another possible cause of pain that she developed through Socratic questioning, and environmental adjustments played important roles in preparing her to accept cognitive therapy, achieve delusional remission, and maintain her state of remission, respectively. The interventions implemented in this case provide insights for addressing social isolation and loneliness in late-onset psychosis.

Awareness of Dementia Care Amongst the Staff Working at Day-care Centers and Nursing Homes in Macao.

BACKGROUND: The staff working at day-care centers and nursing homes are in a key frontline for early detection of older people living with dementia, however, whether the staff were well prepared and if they were appropriately trained were still little known. METHOD: A cross-sectional survey was conducted and the validated questionnaires exploring the awareness of dementia care, in terms of knowledge, attitude and preventive practice domain, were given to the staff working at day-care centers and nursing homes in Macao. RESULTS: 272 samples were approached and scores of knowledge was 76.23 ± 19.62, attitude was 80.05 ± 8.92 and preventive practice was 75.59 ± 13.88, among which knowledge and preventive practice were positively related to attitude, and knowledge, attitude and preventive practice were negatively related to age. Health care assistants' knowledge were less than social workers, managers, health professionals and clerk. Attitude of health care assistants were less positive than social workers and health professionals. DISCUSSION: Health care assistants and older staff had less knowledge and less positive attitude. Trainings to improve knowledge, attitude and preventive practice amongst health care assistants and older staff were recommended strongly.

Unveiling the shadows: Parental perceptions and familial impact of daycare abuse of preschool children.

BACKGROUND: Preschoolers are at an increased risk of experiencing abuse, especially from caregivers. Early child abuse has adverse continuances on children's short and long-term development. The majority of previous studies were conducted in the 1990s in the United States, focusing primarily on sexual abuse. Despite the recently increasing public awareness of daycare abuse (DA), empirical studies on this topic have not yet been conducted in Israel. OBJECTIVE: The current study was designed to examine parents' perceptions regarding the DA of their preschool children. METHOD: The data were collected through semi-structured, in-depth interviews with 14 parents of children who underwent DA. Qualitative analysis was performed on the narratives of the participants. FINDINGS: Three main themes were identified: 1) parental shock, 2) community echoes, and 3) ripples of trauma. The study revealed the dramatic consequences of DA on children and their families. The families dealt with the consequences of the traumatic DA event, which destabilized almost every part of their lives. The study found that parents felt alone and without assistance from the authorities while facing the consequences of the DA. CONCLUSIONS: In examining the parents' perspectives, the current study's findings presented essential empirical knowledge regarding the DA phenomenon and encouraged future studies in this area. This study has the potential to serve as a basis for the creation of professional training programs.

Prospective observational study of nutritional status and oral supplement utilization in users of an elderly daycare service, employing a web-based Mini Nutritional Assessment Form (MNA plus).

Introduction: Seniors are vulnerable to frailty, a condition linked to falls, fractures, hospitalizations, and sarcopenia. Even with regular meals, senior daycare users are at risk for malnutrition. Methods: This study assessed malnutrition risk in daycare users, using the web-based Mini Nutritional Assessment Form (MNA®-SF). Individuals identified as malnourished or at risk were examined for changes in nutritional status with and without oral nutritional supplementation (ONS). Results: Of 507 subjects, 138 (27.2%) were malnourished or at risk. Discontinuation rates were 20.0% (7/35) for the ONS group and 40.0% (10/25) for the regular care (RC) group. Among 29 patients with measurable weight change after six months, 19 (ONS group) and 10 (RC group) participated. The ONS group exhibited significant increases in body weight (+1.4 ± 2.9 kg, p < 0.01), body mass index (BMI) (+0.6 ± 0.9 kg/m2, p < 0.01), calf circumference (+3.2 ± 0.2 cm, p < 0.01), and grip strength (+1.2 ± 1.9 kg, p = 0.069). Conversely, the RC group showed no significant increases in body weight (+1.0 ± 1.9 kg, p = 0.146), BMI (+0.4 ± 0.8 kg/m2, p = 0.176), or grip strength (-0.7 ± 1.7 kg, p = 0.327), with decreased grip strength and calf circumference (-0.8 ± 0.9 cm, p < 0.05). In the ONS group, 52.6% (10/19) consumed over 400 kcal/day of ONS, and 84.2% maintained this intake for three months. Malnutrition is prevalent among daycare users. Conclusion: ONS influences weight, BMI, and calf circumference, potentially reducing discontinuation rates. Clinical trial registration: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000049767, UMIN000043580.

Socio-familial environment influence on cognitive and language development in very preterm children.

BACKGROUND: Preterm children are at increased risk of cognitive and language delay compared with term-born children. While many perinatal factors associated with prematurity are well established, there is limited research concerning the influence of the socio-familial environment on the development of preterm children. This study aims to assess the relative impact of perinatal and socio-familial risk factors on cognitive and language development at 2 years corrected age (CA). METHOD: This retrospective cross-sectional study included preterm infants with a gestational age <32 weeks and/or a birth weight <1500 g, who underwent neurodevelopmental assessment at 2 years CA. Cognitive and language scores were assessed using the Bayley Scales of Infant-Toddler Development, third edition. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a multivariable model to examine the relationship between developmental delays and perinatal and socio-familial factors. RESULT: The prevalence of language delay was negatively associated with daycare attendance (aOR: 0.25, 95% CI: 0.07-0.85, p < 0.05) and high maternal educational levels (aOR: 0.24, 95% CI: 0.05-0.93, p < 0.05) and positively associated with bilingual environments (aOR: 5.62, 95% CI: 1.46-24.3, p < 0.05). Perinatal and postnatal risk factors did not show a significant impact on cognitive or language development. CONCLUSION: The development of language appears to be more influenced by the socio-familial environment than by early perinatal and postnatal factors associated with prematurity. These findings highlight the importance of considering socio-familial factors in the early identification and intervention of language delay among preterm children.

Finding a secure base: Exploring children's attachment behaviors with professional caregivers during the first months of daycare.

Recent decades have seen a major rise in demand for daycare services for children aged 0 to 3 years, and this has increased research interest in the child-professional caregiver relationship at daycare centers: How does the relationship between children and their new caregivers develop over time? How long does it take for children to settle in at daycare? What variables can influence the settling-in process? These questions are all of the utmost salience and bear crucial implications for children, parents, and daycare practitioners. In this study, we set out to explore the relationship between infants and their new caregivers over the first two months in daycare, using the Professional Caregiver Attachment Diary. The study involved seven Italian daycare centres and 55 professional caregivers, who observed 148 children (M=17.8 months). The children's attachment behaviors were assessed at three time-points: when the children started attending daycare (T1), one month later (T2), and two months later (T3). We found that positive attachment behaviors (Secure and Non-Distressed) increased over time, whereas insecure behaviors (Avoidant and Resistant) decreased. Most of the change took place during the first month. Furthermore, children who had attended more daycare more regularly (with fewer days of absence) displayed fewer avoidant behaviors and a more rapid decrease in resistant behaviors than did children who were absent more frequently. The findings suggest that the PCAD may be usefully deployed to observe and analyze children while they are settling into a new daycare setting, especially in relation to their exploratory behaviors.

Maltreatment in Daycare Settings: A Review of Empirical Studies in the Field.

Daycare maltreatment refers to abusive and/or neglectful acts perpetrated by teachers, directors, non-professionals or volunteers, family members of staff, and peers in a daycare setting. Despite growing evidence of its occurrence, the prevalence and consequences of daycare maltreatment for the child, the parent(s), and their dyad are largely unknown. This qualitative systematic literature review was conducted to synthesize the existing literature referring to daycare maltreatment, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In order to be included in the analysis, the manuscripts needed to report empirical findings regarding maltreatment in daycare settings, be written in English, be published in a peer-reviewed journal or a dissertation, and be accessible by our research team. In all, 25 manuscripts met the above criteria and were included in the review. Our results indicate that reports of daycare maltreatment are characterized by early age of abused children, inferring mainly to sexual, physical, and emotional abuse. The majority of these manuscripts reported caregivers' and teachers' abuse, while peer victimization was reported much less. In addition, the findings demonstrated a higher representation of female perpetrators compared to abuse in other scenarios. Although some indications of long-term implications are reported in the manuscripts, a well-validated measure for assessment of daycare maltreatment seems to be lacking. These findings contribute to a more nuanced understanding of the complex experience and ramifications of daycare maltreatment, providing insight into its multi-faceted implications.

Process reengineering using DMAIC framework for reduction of waiting time in daycare infusion therapy for better patient experience.

Daycare infusion therapy is an integral aspect of oncology, but increased waiting time raises concerns for patients. Patient-reported experience measures prompted the need to evaluate reasons for prolonged appointment delays. This study seeks to analyze and address patients' concerns, to streamline the process flow and reduce waiting time for daycare infusion therapy thereby enhancing patient experience. The define, measure, analyze, improve, and control methodology was implemented, and its impact on reducing waiting times was evaluated. The objective is to ensure that >85% of patients enter the daycare infusion unit within an hour of their appointment time in 6 months. The baseline data for patient waiting times was measured for a period of 2 months, and the average waiting time was determined. Potential causes contributing to prolonged waiting times were identified through time-motion analysis, with a fishbone diagram categorizing potential causes and a Pareto chart prioritizing them. Plan, do, study, and act cycles were conducted for implementing the changes, and a new process flow mapped. Baseline data showed 32% average adherence to the defined turnaround time of 1 hour, with an average waiting time of 108 minutes. Forty causes were identified for increased waiting time, of which eight were key. Adherence to waiting time turnaround time improved from 32% to 89% and the average waiting time decreased by 59 minutes from 108 minutes, increasing patient satisfaction index by 7.5%. The balancing measures include an increase in operational efficiency and throughput of the unit and the inventory levels of oncology medicine were decreased, leading to a 50% reduction in inventory value, while medication error declined by 0.62%, improving patient safety. The project gained tangible and intangible benefits impacting staff, patients, and relatives while improving operational efficiency. This study, with its scientific and systematic approach, enhanced patient satisfaction, patient safety, and better utilization of resources.

The transition of care from farm-based daycare for people with dementia: The perspective of next of kin.

PURPOSE: The aim of the present study was to explore the next of kin's experiences with the transition for people with dementia from a farm-based daycare (FDC) to another service in the municipality. METHODS: The study has a qualitative, descriptive design. Eight semi-structured interviews with next of kin were conducted. The data were analysed in accordance with content analysis. RESULTS: Through the analysis three main categories were developed: (1) Bearing the burden, (2) Being in transition, and (3) Feeling supported. The transition period was highly stressful for next of kin due to the exacerbation of their relatives' dementia symptoms. The next of kin focussed on optimizing the everyday lives of their relatives with dementia, even at the expense of their own well-being. Most participants experienced support from FDC, healthcare services and their informal network. CONCLUSIONS: The study contributes important insights into the next of kin's experiences. Good quality service, close dialog, information, and support between the different part in the transition process, can be useful for the further development of services with good quality and to reduce the negative effects of care on next of kin.

Supporters' experiences of sensory characteristics of children with profound intellectual and multiple disabilities in after-school daycare centres: A qualitative study.

AIM: To examine how supporters working at after-school daycare centres, who are involved in the lives of children with profound intellectual and multiple disabilities in the community, pay attention to the sensory characteristics of these children and provide support. DESIGN: A qualitative descriptive design. METHODS: Data were collected through semi-structured interviews with 20 supporters in after-school daycare centres. Interview transcripts were analysed via qualitative content analysis. RESULTS: The participants' years of involvement in supporting children with profound intellectual and multiple disabilities ranged from 0.5 to 40 years, with an average of 9.8 years. Data were classified into 68 subcategories, 11 categories and three themes: understanding sensory characteristics and devising support, systematic support and challenges supporting the children. Supporters dealt with physical complications and cooperated with other caregivers to understand and respond to children's sensory characteristics. Difficulties dealing with sensory characteristics, challenges due to the supporters' own characteristics and challenges with the facility's infrastructure were identified. The findings could guide sensory characteristics considerations and support systems in after-school daycare facilities for children with profound intellectual and multiple disabilities. Both support content and challenges in supporting these children were identified.

A web-based care assistant for caregivers of the elderly: Development and pilot study.

Background: The aging population in Korea has driven a surge in demand for elderly care services, leading to significant growth in elderly welfare facilities, particularly Adult Daycare Centers (ADCs). However, despite advancements in care facilities, caregivers continue to face challenges in providing suitable elderly care due to difficulties arising from gaps in the latest information on the elderly and their coping abilities. Objective: The objective of this study is to develop and evaluate the effectiveness of the elderly care assistant system, which facilitates the sharing of information and knowledge necessary for elderly care among caregivers. Methods: The ECA system was designed to support knowledge sharing through a knowledge management system based on an ontological knowledge model, with a web-based user interface for improved accessibility. A field trial was conducted at ADC in Seoul from August 17 to September 21, with eight caregivers participating. A mixed-methods approach, involving both surveys and interviews, was employed to gauge the ECA system's effectiveness. Results: The study found that the use of the ECA was beneficial in promoting knowledge sharing among caregivers. Additionally, caregivers noted the potential benefits of using the ECA in conjunction with family caregivers, who can offer additional information and perspectives on elderly care. Conclusions: This study presents preliminary evidence of the potential benefits of a care knowledge sharing system among various caregivers in elderly care. Although the elderly care assistant effectively promotes knowledge sharing, more research is needed to fully understand its impact on elderly care outcomes.

Is a Mesh Really a Mess: A Self-Tailored Polypropylene Mesh as a Retropubic Tension-Free Vaginal Tape Under Local Anesthesia in a Tertiary Healthcare Center Experience in India.

Objective The primary objective of this study was to evaluate the feasibility of performing retropubic mid-urethral transvaginal tape (TVT) with self-tailored ordinary polypropylene mesh (STOM) under sedation and local anesthesia in female patients with stress urinary incontinence (SUI). The second objective was to evaluate perioperative and immediate postoperative complications, success rates, and cost-effectivity. Materials and methods Forty-two subjects treated for stress urinary incontinence using STOM under local anesthesia were reviewed. Pre- and postoperative evaluation included assessment of valid questionnaires such as the urogenital distress inventory (UDI) and medical, epidemiologic, and social aspects of aging incontinence questionnaire (MESA), uroflowmetry in all cases, and urodynamics in some instances. Success rates and complications were compared with published studies. Results The mean operating time was 27 mins, and the median visual analog scale (VAS) score at 12 hours was three. Postoperative MESA and UDI scores had significant improvement. The mean hospital stay was 18 hours. Mean preoperative and postoperative Q max had no significant difference. With a mean follow-up of 27.32±3.29 months, the cure was seen in 38 patients (90.4%), improvement in three patients (0.07%), and failure in one patient (0.02%). Mesh-related complications (extrusion) occurred in one patient. The sling cost was reduced from approximately $500 (Gynecare TVT sling; Ethicon Inc., Somerville, NJ, USA) to $12.44 (Ethicon 15 x 7.6 cm Prolene (polypropylene mesh); Ethicon Inc., Somerville, NJ, USA) in our study. Conclusion Performing TVT with STOM under sedation and local anesthesia as a daycare procedure was feasible and cost-effective, has a high success rate, and was associated with minimal complications. It should be considered in developing countries with vast patient burdens, such as India.