Mary Grace Umlauf

Urodynamic changes associated with behavioral and drug treatment of urge incontinence in older women

OBJECTIVES: To describe changes in bladder function and voiding frequency associated with behavioral and drug treatment for urge incontinence and to examine whether these variables mediate the positive effects of treatment on the frequency of incontinence.

PSYCHOSOCIAL ISSUES IN GERIATRIC UROLOGY: Problems in Treatment and Treatment Seeking

Psychological and social issues are important in geriatric urology because they affect not only the patients ability and willingness to seek out therapy, but also their ability to benefit from it. Many older adults with problems of bladder control, such as frequency, urgency, nocturia, and incontinence are deterred from seeking treatment by factors such as social disapproval and belief that bladder symptoms are normal or untreatable. Many older adults who present for treatment experience limitations of mental status or functional ability that merit attention because they can interfere with learning, motivation, and cooperation needed for successful treatment. Strategies are described that help to address these psychosocial issues and needs in older patients.

Knowledge of substance abuse among high school students in Jordan.

Objectives: The purpose of this study was to explore the knowledge, attitude, and beliefs about substance abuse among Jordanian adolescents (aged 15-18 years). Design: A descriptive design was employed using a self-administrated questionnaire to collect the data from 400 high school students. Methods: A multistage, random sample was generated in selecting schools from the educational directorate located in a large urban city located in the north of Jordan.This city district contains 23 public secondary schools and serves 56.8% of the adolescents in the entire province. Results: The results revealed the following: Students of both sexes were knowledgeable about aspects of substance abuse, including its harmful effects on the body and society and reported that even occasional or frequent use of cigarettes, alcohol, and other drugs was extremely harmful. A majority of the students perceived substance abuse as a problem, although the older students were more acutely aware than the younger group. However, the results revealed that the students lack in-depth knowledge of substance abuse. In addition, the adolescents consistently refer to Islamic principles forbidding use of intoxicants but mistakenly presume that mosques are sources for assistance regarding substance abuse. Conclusions: Policy makers, health workers, and religious leaders must collaborate to build structured educational programs and readily accessible, evidence-based treatment programs for adolescents. Given that young people constitute the majority of the Jordanian population and that drug trafficking is prevalent in the region, the implications of prevention programs are critical to maintaining gains in public health outcomes as well as economic progress and development in Jordan.

Sleepiness and health in midlife women: results of the National Sleep Foundation's 2007 Sleep in America poll.

The 2007 Sleep in America™ poll, a random-sample telephone survey, provided data for this study of sleep in community-dwelling women aged 40 to 60 years. The majority of the respondents were post- or perimenopausal, overweight, married or living with someone, and reported good health. A subsample (20%) reported sleepiness that consistently interfered with daily life; the sleepy subsample reported more symptoms of insomnia, restless legs syndrome, obstructive sleep apnea, depression and anxiety, as well as more problems with health-promoting behaviors, drowsy driving, job performance, household duties, and personal relationships. Hierarchal regression showed that sleepiness along with depressive symptoms, medical comorbidities, obesity, and lower education were associated with poor self-rated health, whereas menopause status (pre-, peri- or post-) was not. These results suggest that sleep disruptions and daytime sleepiness negatively affect the daily life of midlife women.

Insulin resistance and obstructive sleep apnea: is increased sympathetic stimulation the link?

The science of sleep is in early stages of development, and the biochemical consequences of obstructive sleep apnea (OSA) are slowly being identified. Only recently have investigators begun to identify the commonalities and interaction between OSA and insulin resistance, the underlying pathology of type 2 diabetes. Obesity and increasing age play important parts in the natural history of both conditions, which frequently coexist. The purpose of this article is, first, to examine the extent and strength of studies that have investigated the association between OSA and increased insulin resistance or type 2 diabetes and, second, to propose a model that explains the association and cyclical interaction between OSA, obesity, and insulin resistance.

Health Promotion Behaviors among Jordanians

The purpose of this study was to survey the health-promoting lifestyle behaviors of Jordanian adults (n = 950) and to identify any differences based on gender, age, marital status, income, education level, and health status. Exercise was consistently reported as the most important deficiency in all comparisons. The findings strongly support public health concerns about the growing prevalence (35%) of cardiovascular mortality. There is clear evidence of the cardiogenic Westernized lifestyle pattern of too little exercise, compounded by poor nutrition, and stress. The results strongly support the development of social marketing programs to increase economical and culturally acceptable forms of exercise among children, youths, and women in light of the projected population growth and the limited resources available for secondary and tertiary care.

Knowledge, Attitudes, and Behavior in Avoiding Secondhand Smoke Exposure Among Non-Smoking Employed Women with Higher Education in Jordan

Secondhand smoke (SHS) exposure is a serious public health threat worldwide; in the developing world there are less serious efforts towards controlling women’s and children’s exposure to SHS. Knowledge, attitudes and avoidance practices among Jordanian women have never been thoroughly studied. The purpose of this study was to assess the knowledge, attitudes, and avoidance behavior towards SHS exposure among employed Jordanian women with higher education. Methods A survey was conducted among employed Jordanian women at two universities. A total of 209 women were included in the analysis. Two questionnaires regarding SHS exposure were used to measure knowledge, attitudes and avoidance practices. Results Most respondents were regularly exposed to SHS in various locations during daily life, even though they were very knowledgeable about the dangers of SHS exposure for women and children. However, the subject’s attitudes and avoidance behavior did not reflect the level of knowledge about SHS risks. The results suggests there is a large discrepancy between SHS exposure, knowledge, attitudes and avoidance behavior among highly educated Jordanian women that is likely influenced by culture and traditional gender roles. Public health initiatives are needed in Jordan to address public policy, institutional practices and to empowerment of women to reduce SHS exposure.

The ecology of bipolar disorder: The importance of sleep.

Although much of the emphasis in treating Bipolar Disorder patients is on pharmacotherapy, sleep loss is an important trigger for mania and plays an important role in the condition. The purpose of this paper is to fully explore the chronobiological, environmental, social, and genetic factors that contribute to the sleep disruption that is characteristic of mania and bipolar disorder. This review is important because sleep, chronobiology, and genetics are under-emphasized content areas in nursing education. As a result, many practicing nurses are unaware of the importance of sleep for mental health or what to teach patients to improve both the quality of their sleep and the management of their condition.

Preconception health status of Iraqi women after trade embargo.

OBJECTIVES To describe the preconception health status of Iraqi women in 2001 following the trade embargo imposed on Iraq beginning in 1991 and only partially removed in 1996. DESIGN A descriptive cross-sectional prevalence study. SAMPLE 500 Iraqi women at a premarital clinic in Baghdad in 2001. MEASUREMENTS Women were surveyed for age, area of residence, menstrual history, household crowding, consanguinity, and a family history of congenital problems. Clinical findings regarding height, weight, and hemoglobin level were included in the data. RESULTS Almost one third of the women were below the age of 20 and the majority were between 20 and 25 years of age. More than half of the women in this study had an intermediate-level education or less and lived in very crowded housing. Most of the women were anemic and reported a delay in menarche, suggesting malnutrition. Most of the women were planning consanguineous unions even though many reported congenital conditions in their family of origin. CONCLUSIONS Young Iraqi women who endured embargo needed, and continue to need, aggressive preventive health services to recoup health gains lost during the 1990s and to address prevention of common congenital disorders.

22q11 Deletion Syndrome: Is That What They Used to Call . . . ?

PURPOSE 22q11 deletion syndrome (22q11DS) is a very common, but commonly overlooked, disorder that has many variable features, such as serious heart defects, speech and articulation problems, immune compromise, learning problems, pervasive developmental disorders, and a late appearing phenotype of this condition--mental illness. CONCLUSION Persons with 22q11DS are likely to be medically complex patients with pervasive developmental disorders and late appearing mental problems. PRACTICE IMPLICATIONS Establishing this diagnosis is useful to families and healthcare providers to anticipate and address immediate and future issues surrounding health promotion, disease prevention, and health maintenance.