69 research outputs found
The REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey in Europe: Country-specific comparisons of postmenopausal women's perceptions, experiences and needs
No full textUsing advanced analytics to help identify women who are more likely to have a severe subjective experience of vulvovaginal atrophy: a modeling study
No full textObjective To develop a model to identify women likely to be severely impacted by vulvovaginal atrophy (VVA), based on their experience of symptoms and non-clinical factors.Methods Multivariate statistics and machine-learning algorithms were used to develop models using data from a cross-sectional, observational, multinational European survey. A set of independent variables were chosen to assess subjective VVA severity and its impact on daily activities.Results A final composite model was selected that included three categories of variables: clinical severity, patient demographics/clinical characteristics and Day-to-Day Impact of Vaginal Aging (DIVA) variables related to emotion/mood, impact on lifestyle and frequency of sex. The model accurately classified 71% of women. Three DIVA variables (feeling bad about yourself, desire/interest in sex, physical comfort related to sitting) explained much of the variation in the dependent variable of the model. Over 90% of the impact of VVA relates to certain psychosocial and behavioral aspects that can be identified without the need to consider physical signs/symptoms.Conclusion Non-clinical factors can contribute significantly to the overall VVA burden.Questions used in developing the composite model could form the basis of an instrument to help screen women prior to clinical consultation and improve VVA management
Macro-regional variation in attitudes toward and experiences of vulvar and vaginal atrophy among Italian post-menopausal women: a post hoc analysis of REVIVE survey data
No full textItalian participants in the European REVIVE survey reported that vaginal and vulvar atrophy (VVA) impaired various aspects of their lives, notably the ability to enjoy sex. The aim of the present study was to explore regional differences in knowledge, experiences, and treatment of VVA in the Italian REVIVE sample (n = 1000), which was analyzed according to region of residence. While many respondents were unfamiliar with the VVA condition, most could relate their VVA symptoms to the menopause. The rate of diagnosis of VVA was twice as high in Central Italy as in the North-East. For individual VVA symptoms, 25.4-41.6% of respondents judged that the symptom had worsened over time. There were no significant regional differences for symptoms in terms of reported rate, change in severity, impact on sexual activity, or health-care visits. Testosterone cream and OTC medication based on hyaluronic acid showed significant regional differences in lifetime rates of use. In Italy, there are modest regional differences in knowledge, diagnosis, and treatment of VVA, some of which may be explained by inter-regional differences in health care. Further efforts are needed to ensure that Italian women are properly informed about VVA and have access to appropriate health care and treatments
Attitudes and perceptions towards vulvar and vaginal atrophy in Italian post-menopausal women: Evidence from the European REVIVE survey
No full textObjectives To achieve a deeper understanding of the attitudes and perceptions of Italian post-menopausal women (PMW) regarding vulvo-vaginal atrophy (VVA). Study design As part of the EU REVIVE study, an online survey was conducted in four European countries; the Italian arm comprised 1000 participants from representative regions of Italy. Main outcome measures The perceptions, experiences and needs of Italian PMW in relation to sexual and vaginal health. Results The most frequent VVA symptom was vaginal dryness (78%). Usually, the severity of symptoms was similar to or worse than when they first appeared. This was particularly true for dyspareunia, the most bothersome symptom (76%). VVA symptoms had a significant impact on Italian participants' ability to achieve pleasurable relations (74%) and spontaneity (70%). Although 75% of participants were still sexually active, their sex drive had been reduced by a third because of VVA. Women expected that doctors would start a discussion of menopausal symptoms and sexual health, but this was rarely the case (11%). Most women had been treated with a vaginal over-the-counter (OTC) product. Women who had discussed their condition with a physician were more likely (68%) to be under treatment for VVA than those who had not (36%). Low compliance was associated with symptom improvement (23%), not having annoying symptoms (22%), and the impossibility if restoring the vagina to normal (14%). Common reasons for treatment dissatisfaction were related to route of administration or discomfort. Lack of efficacy and fear of a hormone effect were perceived as the main limitations for OTC and local estrogen products, respectively. Conclusions Despite the commonness of VVA and its significant impact on quality of life, the condition remains underdiagnosed in Italy. Discussion of symptoms with doctors influences the diagnosis, and patients' satisfaction with available treatments is not high
The form and use of everyday streets
No full textEveryday streets facilitate various activities and movements, both indoors and outdoors. The second section of this book addresses the following question: What is the relationship between the urban form of everyday streets and the activities that occur on them?Urban Desig
Introduction to Everyday Streets
No full textEveryday streets are both the most used and the most undervalued of cities’ public spaces. They constitute the inclusive backbone of urban life – the chief civic amenity – though they are challenged by optimisation processes. Everyday streets are as profuse, rich and complex as the people who use them; they are places of social aggregation, bringing together those belonging to different classes, genders, ages, ethnicities and nationalities. They comprise not just the familiar outdoor spaces that we use to move and interact and the facades that are commonly viewed as their primary component but also urban blocks, interiors, depths...Urban Desig
No increase in incidence or risk of recurrence of breast cancer in ospemifene-treated patients with vulvovaginal atrophy (VVA)
No full textObjective: To estimate the incidence and recurrence of breast cancer (BC) in patients with vulvovaginal atrophy (VVA) treated with ospemifene and matched untreated VVA patients using real-world data.
Study design: Retrospective matched cohort study.
Main Outcome Measures: VVA patients were identified from the 2011–2018 US MarketScan® insurance claims database. For incidence, ospemifene-treated VVA patients without evidence of BC prior to index treat- ment were matched to two untreated VVA controls similarly without history of BC on age, index VVA year, geographic region, Charlson Comorbidity categories, and follow-up time. BC after the index treatment was identified by BC diagnosis codes, mastectomy, chemotherapy, or radiation procedure. Incidence rate, rate ratio (RR) and their 95 % confidence intervals (CI) were calculated. The process was repeated to estimate BC re- currence in patients with a history of BC in 1:1, 1:2 and 1:3 matches.
Results: 1728 ospemifene users and 3456 untreated patients met the inclusion and matching criteria for asses- sing incidence. The average number of days for which ospemifene was supplied was 314 (standard deviation [SD] = 340). Average follow-up time from index treatment was 937 days (SD = 392) for treated patients and 915 days (SD = 396) for controls. BC incidence rates per 1000 person-years was 2.03 (95 % CI: 1.06−3.91) for treated patients and 3.53 (95 % CI: 2.49−4.99) for controls (RR = 0.58, 95 % CI: 0.28−1.21). No difference in recurrence was observed between ospemifene-treated and matched untreated patients. Ten (32.3 %) treated vs. 25 (40.3 %) controls in the 1:2 matched analysis had a recurrence.
Conclusion: No differences were observed in the BC incidence and recurrence rates in ospemifene users com- pared with matched controls
Leisure Coast City. A comparative history of the urban leisure waterfront. Barcelona. Chicago. Buenos Aires. 1870-1930
No full text*** NOTIFICATION *** With reference to this thesis, I express my debt to Dr. Sonia Berjman’s numerous and pioneer publications on Buenos Aires landscape history, which were not only inspiring but also the basis of my analysis of Courtois, Bouvard, Thays, Carrasco brothers, Forestier and other landscaper’s works in that city. This chapter 4 would not have been possible without her researches and the sources, ideas and relations that she has brought to the forefront. I apologize for not having given her proper credit in the original thesis text. I further state that Dr. Sonia Berjman ’s book Benito Javier Carrasco: sus textos. (Facultad de Agronomía. Universidad de Buenos Aires, 1997, 258 p.) has been - in a great part - the source basis for my article ‘La Costanera Sur de Buenos Aires. Borde y horizonte de la ciudad’. In: Public Art in Urban Design. Vol. 11, 10.2008, pp- 30-40. http://www.ub.edu/escult/Water/water11/Water011.pdf p. 65 . I regret not having given her proper credit in the printed and web publications. Agustina Martire *** ABSTRACT *** The urban waterfront is in the spotlight. During the last decades harbour facilities have been moved away from urban centres. Projects for the recovery and restructuring of obsolete industrial areas by the water are sprawling all over the globe. The process of recovery of the urban waterfront that takes place currently began more than a century ago with the discovery of the urban waterfront as a space of leisure. Waterfronts, as urban spaces, have followed a development signed by different conflicts than those of the rest of the city. On the one hand, they have been spaces especially open to intervention, for their location created little conflict with the social order of cities. On the other hand they have been conflicted spaces regarding the struggle between the installation of harbour facilities and leisure spaces, linked to jurisdictional problems between national and metropolitan authorities. The use of the urban waterfront as leisure space was different in Europe and in North and South America. In most of European capitals the waterfront was occupied by harbour facilities, and due to commercial expansion, these spaces were growing and became segregated from urban space. This process did not allow the development of leisure areas on the waterfront. On the other hand, in North and South America the waterfronts became spaces of opportunity and the development of harbour and leisure space was contemporary and flexible, giving an important role to landscape on the waterfront. The cases of Barcelona, Chicago and Buenos Aires appeared to be the most suitable for the analysis of this phenomenon. They appear as models for other waterfront cities throughout the western world. Incidentally they were also hosts of international exhibitions in the period between 1870 and 1930. This project studies the issues of these spaces with an analytical and critical view, searching for primary and secondary sources to evaluate the use of leisure in the projects for the urban waterfront and the way this has been practised in three particular case studies. The reciprocal influence between leisure activities, urban design and mass events are analysed as a main backbone of this research.Architectur
Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women
No full textObjectives: To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women.Study design: Cross-sectional survey conducted in postmenopausal women aged 45-75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale - revised (FSDS-R) were filled out.Main outcome measures: Association between treatments for VVA and symptom frequency.Results: Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p < 0.0005). The systemic hormone group presented with fewer VVA symptoms, lower vaginal impact (DIVA), and better sexual function (FSFI and FSDS-R) and vaginal health. The rates of sexual distress and vulvar atrophy were higher in the non-hormonal treatment group. No significant differences were found according to treatment duration.Conclusions: Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments. Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman
Santi allo specchio: Bernardino da Siena e Pietro martire. Osservazioni a partire dalle fonti iconografiche
No full textThis chapter’s ultimate goal is to unveil the underlying significance of a widespread association in Late Medieval iconology, such as the one between Peter Martyr and Bernardino of Siena. Through the analysis of several case studies, the author succeeded in casting a fresh light on the image of a duo which throughout the Quattrocento was embedded with multiple and different meanings.L’obiettivo di questo contributo è quello di investigare il significato di un’associazione diffusa nell’iconologia tardo‐medievale, quale quella tra Pietro Martire e Bernardino da Siena. Attraverso l’analisi di diversi casi di studio, l’autore getta una nuova luce sull’immagine di un binomio che nel corso del Quattrocento si è caricato di molteplici e differenti significati
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