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British Medical Journal Oct 1959
Topics: Enuresis; Humans; Nocturnal Enuresis; Toilet Training
PubMed: 13816832
DOI: 10.1136/bmj.2.5153.666 -
International Neurourology Journal Mar 2022Controversy exists regarding the role preoperative urodynamic study for asymptomatic closed spinal dysraphism as it has failed to reveal the benefit in surgical decision...
PURPOSE
Controversy exists regarding the role preoperative urodynamic study for asymptomatic closed spinal dysraphism as it has failed to reveal the benefit in surgical decision and expectation of urological outcomes. We explore the relationship between preoperative videourodynamic study and postoperative urological outcomes after toilet training completed, focusing on their capability of spontaneous voiding.
METHODS
We retrospectively reviewed the data of 181 patients who underwent preventive spinal cord untethering and followed at least till the completion of toilet training. Before untethering, patients underwent preoperative videourodynamic study. Postoperative voiding function was evaluated in 3 phases: (1) till postoperative 6 months, (2) till the completion of toilet training, and (3) 2 years after toilet training. Changing distribution of emptying pattern at each period was described. Also, relevance to preoperative urodynamic parameters on spontaneous voiding and urinary continence after toilet training was assessed.
RESULTS
Spinal lipoma and low lying conus were found in 145 (80%) and 128 patients (70.7%), respectively. Spontaneous voiding was found in 125 (69.1%), 164 (90.6%), and 162 patients (89.5%) at postoperative 6 months, till the toilet training, and 2 years after toilet training, respectively. Videourodynamics helped to clarify the presence of vesicourethral synergy. This was correlated with spontaneous voiding at postoperative 6 months and better urinary continence after 2 years of toilet training.
CONCLUSION
Eventual spontaneous voiding was achieved till toilet training in 90% patients following preventive untethering. Those showing preoperative vesicourethral synergy was associated with faster achievement of spontaneous voiding and better urinary continence when they enter elementary school.
PubMed: 35183068
DOI: 10.5213/inj.2142246.123 -
Journal of Infection and Public Health Dec 2020The increasing emergence and spread of multiresistant microorganisms in hospital wards is a serious concern. Traditional protocols are often not sufficient to protect...
BACKGROUND
The increasing emergence and spread of multiresistant microorganisms in hospital wards is a serious concern. Traditional protocols are often not sufficient to protect patients susceptible to serious and life-threatening infections, therefore new strategies for decontaminating hospital environments are crucial to reducing microbial transmission and the spread the nosocomial infections. The adoption of modern technologies is indicated to supplement traditional methods and to improve desired levels of surface disinfection.
AIM
This work aims to report the development, implementation, and validation of cleansing and sanitizing procedure for critical clinical settings through the innovative use of disposable cloths pre-impregnated with solutions containing different active formulations and biocidal agents, relating to the areas to be treated (low, moderate, high-risk).
METHODS
The implementation and validation of the sanitizing system were conducted in different wards of two healthcare structures. The protocol for the study involved a structured selection of representative surfaces, such as the floor, bathroom, desk, and beds. Microbiological analyses were performed according to ISO 4833-1:2013.
FINDINGS
The efficiency of the proposed system was measured through the estimation of total microbial count values on the different surfaces before and after the sanitization operations by traditional methods and by the system described here. The results demonstrated a significant reduction in the microbial count that always fell below the threshold value. For the analyzed surfaces such as shower tray, bathroom floor, toilet edge, the traditional system had an effectiveness of less than 10%, whereas pre-impregnated cloths succeed to eliminate about 90% of the bacteria present. As an example, on the floor we observed a microbial count reduction from >42 to 10CFU/11cm with the new method (76% of colonies were destroyed), while with the traditional one we have a reduction from >42 to 28CFU/11cm (33% of microbial colonies). Moreover, the advantages of using this sanitization system are not limited to disinfecting surfaces and limiting cross-contamination but involve all activities related to the cleaning and disinfection operations, including the training and education of the operators and traceability of the operations.
CONCLUSIONS
The innovative disinfection and cleaning protocol used in the present study proved to be a highly valuable alternative to the traditional cleaning procedures in healthcare settings for the sanitizing process of all kinds of surfaces. All tools were specifically designed to improve disinfection efficiency and to reduce the problems associated with traditional methods, such as preventing cross-contamination events, limiting the physical efforts of operators, and avoiding incorrect practices. Our findings add support to the knowledge that an effective sanitization procedure is critical in minimizing microorganisms' transmission and cross-contamination.
Topics: Cross Infection; Decontamination; Disinfection; Hospitals; Humans
PubMed: 33289645
DOI: 10.1016/j.jiph.2020.09.020 -
Global Pediatric Health 2020There is much uncertainty about when to start toilet training. Age cannot be a strict stand-alone criterion, as every child has its own pace of development. We observed...
There is much uncertainty about when to start toilet training. Age cannot be a strict stand-alone criterion, as every child has its own pace of development. We observed toilet training (TT) related development signs (DS) in healthy toddlers and determined which can help to define the proper time to start TT and to predict success. The study group consisted of 269 healthy children, in different stages of TT: not started, during, and after completion. Sitting stable, picking up small objects, and spontaneously putting objects in containers were present in all children and had no predictive value. All other DS were significantly more present in those who had started and became more prevalent during completion of TT. Age had a significant association with 13/15 DS. Understanding and following instructions, and having a broader vocabulary were significantly more present when TT had been started. Dry during midday nap reached no significance.
PubMed: 32923525
DOI: 10.1177/2333794X20951086 -
Neurology International Jul 2021Angelman syndrome is a rare genetic disease affecting the central nervous system and neurobehavioral development causing severe mental, linguistic, and physical... (Review)
Review
Angelman syndrome is a rare genetic disease affecting the central nervous system and neurobehavioral development causing severe mental, linguistic, and physical disabilities. The purpose of this review was to analyze the most recent evidence regarding the rehabilitation of subjects affected by this syndrome. The review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses. A total of 3661 studies were identified in the databases. Once the inclusion/exclusion criteria were applied, 15 studies were considered for the paper's preparation. The level of evidence of the studies was established according to the criteria of the Oxford Center for Evidence-Based Medicine-Levels of Evidence. From the selected studies, five rehabilitative approaches emerged: physiotherapy, applied behavioral analysis, toilet training, microswitch-cluster technology, and augmentative and alternative communication. Although the studies did not have a high level of evidence, the reported results appear to be encouraging and pave the way for further studies. It seems that individualized and multidisciplinary rehabilitation interventions help to improve patients' autonomy and quality of life. In some studies, the caregivers' role was fundamental to identify preferences and long-term improvements. Further studies on larger populations and with better methodological quality are needed to confirm the results.
PubMed: 34449677
DOI: 10.3390/neurolint13030036 -
Iranian Journal of Pediatrics Apr 2013There is still controversy about the methods and the age of toilet training that are varied in different cultures. This is a survey of Iranian parents' views about the...
OBJECTIVE
There is still controversy about the methods and the age of toilet training that are varied in different cultures. This is a survey of Iranian parents' views about the appropriate age, the true age, the methods used for toilet training, and the association with voiding problems.
METHODS
Questionnaires were filled-out containing items on demographic data, the parents' view, the method applied, and the age at which toilet training was accomplished in children aged 2 months to 5 years. In addition, pediatric lower urinary tract scoring system questionnaires were distributed among 217 children aged 5-15 years with lower urinary tract symptoms between 2008 and 2010 in outpatient clinics. P<0.05 was considered significant.
FINDINGS
566 children (335 girls and 231 boys) were assigned to the study. In asymptomatic group, the majority of parents believed that the appropriate age to start toilet training was 1-2 years. The method used by the parents was intensive in 52% and child-oriented in 44%. There was strong reverse correlation between the level of education of father with applying punishment for training and direct correlation between toilet refusal and the later age of completing toilet training (LR: 6.3, P<0.05). The mean age of completing toilet training was about 23 months in asymptomatic and 23.7 months in symptomatic children (P>0.05). There was no correlation between wetting episodes at day or night and the age of toilet training.
CONCLUSION
Intensive approach was more popular and the age of toilet training had no influence on the lower urinary tract symptoms.
PubMed: 23724175
DOI: No ID Found -
Journal of Korean Neurosurgical Society May 2020To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic...
To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic bladder in developing children, neurosurgeons often face difficulty in detecting urological problems in patients with TCS. From a urological perspective, diagnosis of TCS in developing children is further complicated due to the differentiation between neurogenic bladder dysfunctions and transient bladder dysfunctions owing to developmental problems. Due to the paucity of evidence regarding evaluation prior to and after untethering, I have shown the purpose and tools for evaluation in my own practice. This may be tailored to the types of neurogenic bladder, developmental status, and risks for deterioration. While the urodynamic study (UDS) is the gold standard test for understanding bladder function, it is not a panacea in revealing the nature of bladder dysfunction. In addition, clinicians should consider the influence of developmental processes on bladder function. Before untethering, UDS should reveal synergic urethral movement, which indicates an intact sacral reflex and lack of TCS. Postoperatively, the measurement of post-void residual urine volume is a key factor for the evaluation of spontaneous voiders. In case of elevation, fecal impaction, which is common in spinal dysraphism, should be addressed. In patients with clean intermittent catheterization, the frequency-volume chart should be monitored to assess the storage function of the bladder. Toilet training is an important sign of maturation, and its achievement should be monitored. Signs of bladder deterioration should be acknowledged, and follow-up schedule should be tailored to prevent upper urinary tract damage and also to determine an adequate timing for intervention. Neurosurgeons should be aware of urological problems related to TCS as well as urologists. Cooperation and regular discussion between the two disciplines could enhance the quality of patient care. Accumulation of experience will improve follow-up strategies.
PubMed: 32392667
DOI: 10.3340/jkns.2020.0072 -
PloS One 2022Parenting interventions offer an evidence-based method for the prevention and early intervention of child mental health problems, but to-date their population-level...
Parenting interventions offer an evidence-based method for the prevention and early intervention of child mental health problems, but to-date their population-level effectiveness has been limited by poor reach and engagement, particularly for fathers, working mothers, and disadvantaged families. Tailoring intervention content to parents' context offers the potential to enhance parent engagement and learning by increasing relevance of content to parents' daily experiences. However, this approach requires a detailed understanding of the common parenting situations and issues that parents face day-to-day, which is currently lacking. We sought to identify the most common parenting situations discussed by parents on parenting-specific forums of the free online discussion forum, Reddit. We aimed to understand perspectives from both mothers and fathers, and thus retrieved publicly available data from r/Daddit and r/Mommit. We used latent Dirichlet allocation to identify the 10 most common topics discussed in the Reddit posts, and completed a manual text analysis to summarize the parenting situations (defined as involving a parent and their child aged 0-18 years, and describing a potential/actual issue). We retrieved 340 (r/Daddit) and 578 (r/Mommit) original posts. A model with 31 latent Dirichlet allocation topics was best fitting, and 24 topics included posts that met our inclusion criteria for manual review. We identified 45 unique but broadly defined parenting situations. The majority of parenting situations were focused on basic childcare situations relating to eating, sleeping, routines, sickness, and toilet training; or related to how to respond to child negative emotions or difficult behavior. Most situations were discussed in relation to infant or toddler aged children, and there was high consistency in the themes raised in r/Daddit and r/Mommit. Our results offer potential to tailor parenting interventions in a meaningful way, creating opportunities to develop content and resources that are directly relevant to parents' lived experiences.
Topics: Adolescent; Child; Child, Preschool; Data Mining; Humans; Infant; Infant, Newborn; Parenting; Parents; Social Media
PubMed: 35108299
DOI: 10.1371/journal.pone.0262529 -
Animals : An Open Access Journal From... Oct 2020Untrained cattle do not defecate or urinate in defined locations. The toilet training of cattle would allow urine and faeces to be separated and stored, reducing...
Untrained cattle do not defecate or urinate in defined locations. The toilet training of cattle would allow urine and faeces to be separated and stored, reducing climate-damaging emissions and improving animal health. In a proof-of-concept study, we evaluated a novel protocol for toilet training in cattle. Five heifer calves (and yoked controls) were trained in the voluntary (operant) behaviours of a toileting chain. Then, reflexive urinating responses were incorporated into the chain, with toileting signalled by a tactile (vibratory) stimulus. On 95% of occasions, the calves inhibited/interrupted urination when receiving the stimulus, and on 65% of these occasions, reinitiated urination in the latrine. Furthermore, during 63% of urinations in the latrine, the calves oriented to the reward location before any food was delivered, providing additional evidence that calves can be successfully toilet trained with food rewards. Yoked controls failed to learn most of the operant elements and all the reflexive responses of toilet training. The results show that reflexive behaviours can be incorporated into voluntary toileting sequences with cattle and extend the range of species that can be toilet trained. Future refinement of the protocol to allow training under practical farm conditions offers the potential to mitigate climate damage and improve animal health.
PubMed: 33076551
DOI: 10.3390/ani10101889