Search

Objectives (1) To determine whether advertising nighttime tampon use for up to eight hours was understood to be consistent with label recommendations and (2) to determine whether television and print advertising with this message affected tampon wear times in adults and teens. Methods (1) A comprehension study (online advertising and follow-up questionnaire) among women aged 14–49 years (300 per group) who viewed either the test or a control advertising message; (2) Diary-based surveys of tampon wear times performed prior to ( n = 292 adults, 18–49 years, 74 teens, 12–17 years) and after ( n = 287 adults, 104 teens) the launch of national advertising. Results Significantly more test message viewers than controls stated tampons should be worn less than or equal to eight hours (93.6% vs. 88.6%, respectively, P = 0.049). A directionally higher percentage of test message viewers said they would use a pad if sleeping longer than eight hours (52% vs. 42% of controls). Among the women who used tampons longer than eight hours when sleeping, 52% reported they would wake up and change compared with 45% of controls. No significant difference between baseline and follow-up diary surveys was found among teens or adults in various measures of tampon wear time (mean wear times; usage intervals from less than two hours to more than 10 hours; percentage of tampons used for more than or equal to eight hours; frequency of wearing at least one tampon more than eight hours). Conclusions Advertising nighttime tampon wear for up to eight hours effectively communicated label recommendations but did not alter tampon wear times. The informational intervention had limited impact on established habits.

Feminine hygiene products and menstruation education have transformed the lives of women throughout the world. The P&G Feminine Care Clinical Innovation Research Program has played a key role by expanding scientific knowledge as well as developing technical insights and tools for the development of feminine hygiene products. The aim has been to meet the needs of women throughout their life stages, advancing their urogenital health beyond just menstruation, as well as helping to understand the role of sex hormones in various important health issues that women face. This review article highlights key contributions and research findings in female hygiene products, urogenital health research, and method development. The clinical research team focused on utilizing the results of clinical safety studies to advance the acceptance of feminine hygiene products world-wide. Key findings include that perception of skin sensitivity is not limited to the facial area, but is also relevant to the body and the genital area. Also, they shed light on the role of estrogen in autoimmune diseases as well as premenstrual syndrome. Efforts in the method development area focused on innovative tools that are reliable, predictive of clinical trial results and capable of measuring wear comfort, genital skin health, and the impact of product use on the consumer’s quality of life. A novel method, behind-the-knee (BTK) test, developed to model irritation under normal wear conditions, was the first to account for both chemical and mechanical sources of irritation. The method has been accepted by the FDA as a substitute in clinical trials in some cases, and by American Society for Testing and Materials as a global standard test method. Additional proprietary methods were developed to enhance visual grading of irritation using cross-polarized light, to measure the amount of lotion transferred from sanitary pads, and to evaluate the skin mildness. Finally, the Farage Quality of Life tool was created to measure consumer’s well-being. Based on the results of this extensive clinical research and the newly developed testing methods, the changing needs of women throughout their life stages are better met.

The effect of urine and feces on the skin is a contributing factor to the development of incontinent and diaper dermatitis. The objective of this research was to evaluate skin effects of a given urine or fecal sample on the donor child and/or an adult care

Symptoms without obvious physical cause are commonly reported in medical practice; when chronic, they can have a significant influence on patients' well -being. When traditional medicine is unable to provide relief, sufferers of such conditions often turn to alternative therapies. Western medicine has historica lly viewed the body through a silo model, i.e, a whole consisting of disparate body systems with well -defined boundariesand little relevant interaction. This model ignores the myriad of interactive functions that each system must requireand hinders understanding of syndromes for which etiology is not confined to one organ system, particularly those with a strong psychosocial component. In addition, this model is increasingly shown to be antiquated: recent evidence of Pavlovian conditioning of physiologic al processes (i.e., placebo and nocebo affects, immune system conditioning), physiological distinctions between multiple personalities, and the pervasive effects of psychosocial stress on every body system (down to the level of the genome) demand a new paradigm. As our appreciation exp ands of the innumerable interactions between body systems as well as those between all body systems and the mind, the human body is revealed to be a complex web of neurological, immunologic and endocrine interactions that in t urn modulate a fluid epigenetic base. Firmly planted in the rationalistic viewpoint that is the foundation of Western medicine, but inclusive of the more wholistic (mindand body) view of Eastern medicine, a nexus model which views the body as the seriesof multi-connected, interacting physiological webs is essential to continued progress in medicine.

Bankruptcies at Enron and other corporations led to revelations of widespread wrongdoing: the Corporate Scandals of 2002. Congressional hearings into the scandals culminated in the Sarbanes-Oxley Act (2002). There was extensive media coverage of these events. Using insights from Emerson and Messinger's (1977) Micro-Politics of Trouble perspective, we consider how three newspapers covered the scandals. We focus on how these scandals were defined, explained, and the remedies that were proposed for them. We consider what the Micro-Politics of Trouble perspective offers for an understanding of these scandals, corporate crime and deviance generally, and the media's role in reporting these issues.

This Perspective considers how well Executive Order 13771 addresses the concerns of those who have long supported regulatory reform and how agencies and the Office of Management and Budget might best face the challenges and opportunities associated with implementing regulatory reform.

Manufacturers of consumer products consistently seek to improve marketed products in terms of both safety and efficacy. The desire for continued improvement is seen even in well-established products such as catamenial products which have existed in some form for thousands of years. A recent innovation in the design of menstrual pads is the addition of a surface finish of emollient for the purpose of increasing comfort during wear. The present paper presents different evaluations of such an emollient-treated menstrual pad with a novel absorbent core. These investigations demonstrated product tolerability, defined the optimal formulation and concentration of the emollient-containing finish, and demonstrated successful transfer of the emollient to the relevant skin surface. In addition, enhancement of skin moisturization, associated with exposure to the emollient-treated pad, was demonstrated by several technologies: assessment of skin moisturization by Corneometer®, skin friction testing, and skin capacitance.

Quantitative sensory testing (QST) measures perception thresholds of defined intensities of physical stimuli (e.g. temperature, touch, pressure, vibration). The frequency and severity of subjective sensory effects (itch, burn), though less quantifiable, can be characterized under defined conditions such as product testing. This article reviews two sources of published research on sensory perception on the vulva relative to extragenital sites: (1) systematic, quantitative sensory testing with defined stimuli and (2) vulvar sensory effects reported in clinical trials of external feminine hygiene products. In healthy women, the vulva is less sensitive to punctate touch and vibration than other body sites. Vulvar sensitivity to mechanical stimuli declines after menopause, but is restored by estrogen supplementation. Product trials of feminine wet wipes suggest that vulvar perception of stinging and of skin wetness also are attenuated after menopause, although percep- tions of burning or itching appeared to be unaffected. More systematic, standardized conditions are needed to validate the continued use of QST on the vulva and to better define the characteristics and intensity of subjective vulvar sensations.

Colposcopic inspection of the vagina is a routine component of the safety assessment of intravaginal products. However, colposcopic findings occur frequently in healthy women, raising questions about their relevance to intravaginal product safety. Practical disadvantages limit the utility of colposcopy for evaluating menstrual tampons, among them the presence of background microtrauma, the inability to assess effects during menstruation, and, importantly, the question of whether post-hoc assessments are sufficiently sensitive to detect small inflammatory changes. The Behind-the-knee (BTK) test is an alternative for evaluating inflammatory and tissue dryness effects of physical articles by their repeated application to the popliteal fossa under an elastic bandage. It enables concurrent parallel comparisons of experimental and control articles over time and substantially increases the sensitivity of detecting small changes in tissue inflammation. With this protocol, uncompressed experimental and control tampons yielded comparable relative and absolute erythema scores (after overnight recovery) as did colposcopic assessment of the lower genital tract 3 to 48 hours after menstrual use. Scoring erythema in the BTK test immediately after product removal increased the level of visually discernible inflammation 6-fold. In a study of commercial menstrual pads, subclinical inflammation visualized with cross-polarized light correlated with the frequency of subjective reports of discomfort during the test and discriminated the relative tolerability of the two products determined by market surveillance, providing added confidence in the predictive value of the test. We believe the BTK test to be a valuable alternative to colposcopy for assessing inflammation and dryness associated with menstrual tampons.

Urinary incontinence affects many women over the age of 50 with a substantial detrimental effect on daily ac- tivities and the quality of life. Surgical treatments are invasive, expensive, and not always successful. Patients are also treated with a variety of nonsurgical therapies (physical therapy, pharmaceutical interventions, and various vaginal and urethral inserts), but these have poor compliance rates and limited efficacy in patients with mild to moderate stress urinary incontinence (SUI). Incontinence pessaries have demonstrated efficacy in the treatment of SUI but can cause vaginal ero- sion, foul vaginal odors, and other complications associated with their prolonged residence in the vagina. A novel disposable intravaginal device, which can be worn during active hours and then discarded, was evaluated in this study for safety, ease of use, and efficacy in the treatment of SUI. Fifty-seven women with an average of one episode of SUI per day were fitted with the device, allowed to acclimate to wearing it during the day, and then asked wear the device and pre-weighed incontinence pads for 12 hours a day. Use of this device was significantly associated with a statistically significant decrease in SUI episodes, a decrease in unin- tentional urine output, a decrease in self-reported bladder control difficulty, and a self-reported improvement in quality of life. Subjects rated the comfort of device use during the fitting period, as well as during later device usage. No serious ad- verse events were reported. Results show that the intravaginal device is safe, relatively comfortable, and effective at re- ducing the frequency and psychosocial impact of SUI.

The topic of genital hygiene practices in adolescent girls is under-represented in the literature, despite the fact that poor genital hygiene has a significant potential to negatively impact adolescent health. Moreover, douching (a hygiene practice relatively common among adolescent girls) is linked to numerous serious gynecological problems. Menstruation brings with it a significant hygiene challenge, but in many cultures it is also an important social milestone, surrounded by many cultural practices that profoundly alter a girl’s life. The ability to practically manage menstruation may also impact a girl’s life, depending on the availability of appropriate absorbent products and access to private sanitation facilities. Despite the fact that menstruation is shared by more than half the world’s population, it is a topic that virtually all cultures are uncomfortable discussing at some level, and most girls are ill-informed with regard to menstruation and are unprepared for menarche. Better preparation for ...

The collapse of Enron and revelations about the widespread financial wrongdoing of other corporations prompted congressional hearings in 2002. The hearings culminated in the Sarbanes-Oxley Act, legislation that regulates the accounting industry and imposes prison sentences on executives who lie on their corporations’ financial statements. There was extensive media coverage of Enron and the other high-profile corporations and of the congressional hearings into their wrongdoing. In this paper, we analyze the media representations of these matters. We focus on media coverage of the political language that was offered during the hearings, on the media’s own characterizations of these events, and on how the coverage represented corporate wrongdoing and its control. Our analysis is in three parts. First, we track the ‘bad apples’ language that shifted blame from the corporations onto individuals. Second, we consider the angry denunciations from Congress that resemble status degradation ceremonies. Third, we analyze the hearings as representations of the scandal story using a critical dramaturgy. We argue that the hearings became a spectacle that deflected critique from the economy and shored up the legitimacy of the government and the economy. The usage of critical dramaturgy helps us to make sense of criminological research about the public’s sensibilities of corporate crime.

The global population is aging, especially in Western industrialized nations. In the USA, 38% of adults are over the age of 45 and 13% of adults are over the age of 65 years. Moreover, postmenopausal women now comprise 60% of adults aged over 65 years of age, a proportion that will rise as the population ages. This article reviews some of the more common urogenital health issues among older women. Changes to urogenital morphology and physiology are discussed, highlighting the impact on tissue atrophy, sexuality, prevalence of certain vulvar dermatoses, susceptibility to infection and urinary continence. We review treatment approaches, challenge some of the current paradigms and discuss the need for future research.

The causes of chronic vulvar pain are many and when not accompanied by obvious physical signs they are difficult to unravel. Many common vulvar dermatoses can manifest without obvious erythema or mucocutaneous lesions, as can some less common disorders of both infectious and allergic origin. In addition localized and generalized vulvar dysesthesia, recently defined chronic pain syndromes of neurogenic origin, can also occur in the vulvar area. Chronic vulvovaginal symptoms in early stages are often presumptuously labeled as vulvovaginal candidiasis (VVC) by patients and clinicians alike, which can delay accurate diagnosis. When presented with chronic vulvar pain unaccompanied by verifiable signs, the clinician must effect a sensitive integration of a detailed medical history, including temporal associations of all potential exposures, with more definitive diagnostic tools. Effective use of those available tools can improve initial diagnosis, thus allowing prompt initiation of effective therapy. Optimal therapy will recognize the significant psychological distress that accompanies any chronic pain syndrome.

The ultimate strength of resistance spot welded joints fabricated from a wide range of steel grades, weld button size, and sheet thickness are reported for lap-shear and cross-tension specimens subjected to quasi-static and impact loading conditions. Test data are analyzed with respect to energy, impact speed, and loading rate. Loading rate is identified as a critical, test system independent parameter to reflect the strain rate sensitivity of the steels. An equation is fitted to the ultimate strength test data as a function of loading rate which is proposed to predict the separation of spot welded joint under dynamic loading. The model is validated by test data from open literature generated from other type of specimens and/or dynamic test conditions.

An analysis for an impact system is presented. The results are then used to interpret the test data from dynamic separation of resistance spot welded joints. In this Part I of the investigation emphasis is placed on the design consideration, development of a test system and verification of the design from actual test data obtained from the test system. In addition, the inertia effect of a generic dynamic system is analyzed using the principle of rigid body dynamics. It is shown that the load recorded by a load cell could include both the load experienced by the test specimen and the inertia force generated from the mass and acceleration between the specimen and the load cell, when the load cell is placed on the fixed side of the test specimen. Impact fixtures designed for spot weld strength testing are then studied for the inertia effect.

Aging skin undergoes progressive degenerative change. Structural and physiologic changes that occur as a natural consequence of intrinsic aging combined with the effects of a lifetime of ongoing cumulative extrinsic damage and environment insult (e.g. overexposure to solar radiation) can produce a marked susceptibility to dermatologic disorders in the elderly. As skin ages, the vasculature progressively atrophies. The supporting dermis also deteriorates, with collagen and elastin fibers becoming sparse and increasingly disordered. These changes leave the elderly increasingly susceptible to both vascular disorders such as stasis dermatitis and skin injuries such as pressure ulcers and skin tears, with a steadily decreasing ability to effect skin repair. A parallel erosion of normal immune function produces higher levels of autoimmune skin disorders such as bullous pemphigoid, benign mucous membrane pemphigoid, paraneoplastic pemphigoid, and pemphigus vulgaris. Lichen sclerosus, an autoimmune disorder often occurring in the genital area in older women, is not common but is an important development because of the potential for substantial discomfort as well as serious complications. The prevalence of polypharmacy in this population increases the risk for autoimmune drug reactions, and diagnosis should be undertaken with an awareness that polypharmacy in this population creates a greatly increased susceptibility to drug eruptions that can mimic other cutaneous disorders. Immunologic senescence in the elderly also sets the stage for potential reactivation of the Varicella zoster virus, in which initial dermatologic involvement expands into the major sensory ganglia. Known as shingles, this disorder can be excruciatingly painful with the potential to cause blindness if the optic nerve becomes involved. Dermatoses such as xerosis, pruritus, and eczema are also widespread in the elderly, create substantial suffering in those afflicted, and often prove recalcitrant to treatment. Individual susceptibility to specific types of contact dermatitis changes over the lifetime, and seborrheic dermatitis is substantially more prevalent in the elderly. It is not uncommon for older patients to have multiple impairments, with the potential for cognitive dysfunction as well as impaired vision, hearing, or mobility. In addition, they may not have adequate housing or nutrition, or the financial resources necessary for adequate compliance. Physicians must take into consideration the patient's physical ability to comply with the recommended therapy as well as socioeconomic factors that may impact on compliance. Simple topical regimens are preferable wherever possible in order to maximize compliance and, therefore, efficacy. Extra effort may be necessary to ensure that instructions are accurately followed and that ongoing compliance with the regimen prescribed is actually achieved. Management of dermatologic disorders in the elderly is often less than optimal, due to the fact that the special needs and limitations of this population are not adequately considered. Treatments should consider the intrinsic differences between younger and older patients that may impact on diagnosis and therapy choice. The aged patient is often afflicted with numerous co-morbidities that can influence the choice of therapy. Skin integrity in the elderly is compromised, and safety concerns are increased with the long-term use of any medication prescribed. In addition, the prevalence of polypharmacy in the aged population substantially increases the risk of cutaneous drug reactions, which can profoundly complicate accurate diagnosis of dermatologic disorders. The aged population also needs to be more closely monitored because of increased fragility of the skin and the physical limitations that may hinder compliance with prescribed regimens.

To address the shortage of research-trained pharmaceutical scientists (or doctor of pharmacy [Pharm.D.] scientists), a 2-day pharmacy research conference titled "Pharm.D. Pathways to Biomedical Research" was convened on December 13-14, 2006, at the National Institutes of Health (NIH) campus (Bethesda, MD). The workshop included invited speakers and participants from academia, industry, and government. Forty-two pharmacy schools were represented, including deans and clinical pharmaceutical scientists with current NIH funding. In addition, several pharmacy professional organizations were represented--American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, and the Accreditation Council on Pharmaceutical Education. The workshop was divided into three sessions followed by breakout discussion groups: the first session focused on presentations by leading pharmaceutical scientists who described their path to success; the second session examined the NIH grant system, particularly as it relates to training opportunities in biomedical research and funding mechanisms; and the third session addressed biomedical research education and training from the perspective of scientific societies and academia. We summarize the discussions and findings from the workshop and highlight some important considerations for the future of research in the pharmacy community. This report also puts forth recommendations for educating future pharmaceutical scientists.

The skin undergoes a lifetime of degenerative changes with the potential for genetic mutations occurring from exposure to solar radiation. Benign neoplasms afflict virtually every individual over the age of 65, and more often than not afflicted individuals carry large numbers of growths. Malignant neoplasms, which can create significant morbidity, are increasing in parallel to an increase in prevalence. Although public health measures emphasize prevention through limitation of exposures, the efficacy of sunscreen use is undocumented in the prevention of basal cell carcinoma and malignant melanoma. Development of effective, evidence-based prevention measures should be the focus of future research. The different neoplastic lesions in the elderly population are reviewed.

As life expectancy in industrialized countries increases, appropriate care of elderly skin looms as a dermatologic priority. Skin aging is a complex, multifactorial process whose baseline rate is genetically determined but that may be accelerated by environmental, mechanical, or socioeconomic factors. The intrinsic structural changes that occur with the aging of the skin increase skin fragility, decrease the ability of the skin to heal, increase risk for toxicological injuries, promote the development of various cutaneous disorders, and produce aesthetically undesirable effects like wrinkling and uneven pigmentation. As aged patients represent a larger segment of the population, increased attention to the problems of the aged skin, both cosmetic and beyond, will be necessary and should build on currently successful interventions to improve their quality of life.

Female genital cutting affects over 140 million women worldwide. Prevalent in certain countries of Africa and the Middle East, the practice continues among immigrants to industrialized countries. Female genital cutting is a deeply rooted tradition that confers honor on a woman and her family, yet also a traumatic experience that creates significant dermatological, gynecological, obstetric and infectious disease complications. Little is known about postmenopausal health in cut women. The international community views this practice as a human rights violation. In addition to genital health complications, the medical community must confront an understudied concern of what happens as this population ages. These challenges must be addressed to provide optimal care to women affected by female genital cutting.

Serum concentrations of the sex steroids, which modulate skin structure and function, differ in aging men and women. Serum estradiol levels are unaffected by age in men, but in women, postmenopausal estrogen deficiency results in thinner, drier skin with a lower collagen content and reduced elasticity. Dehydroepiandrosterone and its sulfate form, produced by the adrenals, decline dramatically with age in both sexes, but serum concentrations are consistently lower in women. This steroid becomes the predominant source of both androgen and estrogen synthesis following menopause, and its supplementation increases skin thickness, hydration, and sebum production. Serum androgen levels decline slowly with age in men, but remain higher than in postmenopausal women. Consequently, wound healing, which is inhibited by androgens, is compromised to a greater degree in older men than women. Local synthesis of the sex steroids affects the eccrine sweat glands and hair follicles. Senile sebaceous gland hyperplasia, whereby the sebaceous gland compensates for reduced lipogenesis, is more prominent and occurs earlier in females. Dihydrotestosterone miniaturizes and reduces the number of anagen hair follicles in genetically susceptible men, leading to male-pattern baldness (androgenetic alopecia). Its impact is limited in women because their scalp hair follicles express lower levels of 5α-reductase and androgen receptor and higher levels of aromatase, which reduces the production and action of dihydrotestosterone. Thermoregulation by sweating appears to be compromised with age in both sexes. In short, circulating levels of sex hormones and the expression of key steroidogenic enzymes and receptors within the skin itself influence certain gender differences in aging skin.

Vulvodynia is a chronic pain condition of unknown etiology characterized by vulvar discomfort, in the absence of any recognized medical or neurologic disease. Vulvodynia can affect women of any age, but is mostly diagnosed in young women. Vulvodynia may be overlooked in menopausal women whose vulvar symptoms are generally attributed to vulvovaginal atrophy. The diagnosis of vulvodynia should be included in the evaluation of vulvar pain and dyspareunia in postmenopausal women, especially if the pain persists after adequate treatment of vulvovaginal atrophy. A multifaceted treatment regimen should include pharmacological, physical, and psychosocial therapies. Special considerations in menopausal women include higher incidence of medical problems or medications, decreased tolerance to medications, and need to also adequately treat vulvovaginal atrophy.

Sex steroid hormones, estrogen, progesterone, and androgen play an important role in the gender-based pathophysiological differences observed in skin structure, function, and pathology. Age-related hormonal disturbances also have an impact on skin thickness, elasticity and moisture, skin aging, sebum production, and cellular immunity of the skin. Postmenopausal women experience drastic reduction in skin thickness, elasticity, and moisture as well as impaired wound healing. Marked menopausal changes are also observed in hair growth and sebum production. Estrogen and/or hormone replacement therapy do improve many of these pathophysiological changes. On the other hand, skin diseases such as melanoma seem to be progressive in the presence of estrogen. Thus, overall, age-related hormonal changes are responsible for many dermatologic alterations.

Age-related changes occur in the function and basic structure of the skin and mucosa. With aging, the skin becomes drier, with more tendency to crack. It also becomes thinner, more fragile, and less resistant to infection. Loss of elasticity leaves it more susceptible to injury, while its ability to repair itself diminishes. Skin aging results in less surface sensory perception, thus, increasing the risk of injuries like pressure ulcers. Estrogen deficiencies brought on by menopause can accelerate the degenerative changes associated with aging. In older individuals suffering from incontinence, occlusion, and exposure to moisture, urine and fecal material can result in a cycle of skin damage resulting in incontinence-associated dermatitis. This chapter reviews age-related changes that occur in the skin and mucosa and the effects of menopause and incontinence on these tissues.

Autoimmune diseases, a group of dozens of distinct disorders that target every organ system, affect as much as 10 % of the US population and are increasing in prevalence worldwide. The mechanisms which underlie these diverse diseases are not understood. Autoimmune disease has a strong genetic component, and nearly 80 % of its victims are women, suggesting a strong hormonal contribution. Environmental agents (e.g., lupus-like syndromes induced by pharmaceuticals) can also be a factor. Since the risk of autoimmune disease and levels of circulating antibodies rise with age, a progressive deterioration of the immune system (termed immunosenescence) is implicated.

Despite the fact that women living in industrialized countries are likely to spend one-third of their lives in menopause, the influence of the estrogen withdrawal associated with menopause on many body systems is not fully understood. This is particularly true of the immune system. Autoimmune diseases show a clear predominance in women, implying a central role for estrogen in their development. A thorough elucidation of that role, however, has been challenged by the observation of undeniable contributions to autoimmune disease by genetics, immunosenescence, and environmental triggers as well. The global incidence of autoimmune disease has risen steadily in recent years, worldwide and in all ages, in parallel with steadily increasing global life spans. Given the prevalence of autoimmunity in women and the significant increase in the number of women in their postmenopausal years, the effect of menopause on autoimmunity is an area well deserving of further research effort.

Postmenopausal hypoestrogenism often manifests as vulvovaginal atrophy. The labia shrinks, the introitus narrows, the vagina shortens, and the vaginal mucosa becomes more friable; vaginal pH rises, the microbiota composition is altered, and discharge becomes sparse. These atrophic changes cause vulvar and coital discomfort and also result in a higher risk of urinary tract infections in women with a prior history. Intravaginal estrogen creams and tablets alleviate symptoms of atrophy and restore the characteristics of the vaginal mucosa while limiting systemic effects. Urinary changes also become more common as women age. Stress incontinence is voiding provoked by pressure on the bladder sphincter. Kegel exercises strengthening the pelvic muscle are a conservative treatment. Urge incontinence is uncontrolled urine loss spurred by feelings of urgency that may be caused by abnormal bladder spasms. Interstitial cystitis, thought to involve the leakage of potassium ion across a compromised mucosal barrier, mimics the symptomology of frequent voiding at low volumes observed with urge incontinence. Urge incontinence is treated by behavioral modifications, changes in diet, and antimuscarinic drugs. In the frail older woman with incontinence, vigilant perineal care is needed to prevent the development of incontinence dermatitis. Lichen sclerosus, an uncommon vulvar dermatosis, is an eruption of itchy white papules bilaterally on the vulvar skin and mucosa. A classic presentation is a “figure-eight” configuration of sclerotic tissue around the introitus and anus. Erosive lichen planus, a dermatosis of the mucosa only, and desquamative vaginitis, a bacterial vaginal infection, are two rare conditions which lead to desquamation of the vaginal epithelium and require aggressive antibiotic and corticosteroid treatment, respectively, to limit mucosal deterioration.

This paper describes a course offered to teachers of American Indian students, which focused on the development of culturally relevant activities as part of the science and mathematics curricula. In response to the concern that American Indian students do not find meaning in the curriculum, these activities were embedded in a holistic approach to the curriculum, and the informal science and mathematics of the culture were linked with the traditional school science and mathematics. Informal results suggest that the development of these connections will help American Indian students make sense of what they are learning, both in the context of the culture and in the context of school science and mathematics.

The use of a Doppler asymmetric spatial heterodyne (DASH) interferometer with an Echelle grating provides the ability to simultaneously image the 558 and 630 nm emission lines (e.g., at grating orders of n=8 and n=7, respectively) of atomic oxygen in the thermosphere. By measuring the Doppler shifts of these lines (expected relative change in wavelength on the order of 10⁻⁸), we are able to determine the thermospheric winds. Because the expected wavelength changes due to the Doppler shift are so small, understanding, monitoring, and accounting for thermal effects is expected to be important. Previously, the thermal behavior of a temperature-compensated monolithic DASH interferometer was found to have a higher thermal sensitivity than predicted by a simple model [Opt. Express 18, 26430, 2010]. A follow-up study [Opt. Express 20, 9535, 2012] suggested that this is due to thermal distortion of the interferometer, which consists of materials with different coefficients of thermal expansion. In this work, we characterize the thermal drift of a nonmonolithic Echelle DASH interferometer and discuss the implications of these results on the use of only a single wavelength source during calibration. Furthermore, we perform a finite element analysis of the earlier monolithic interferometer in order to determine how distortion would affect the thermal sensitivity of that device. Incorporating that data into the model, we find good agreement between the modified model and the measured thermal sensitivities. These findings emphasize the fact that distortion needs to be considered for the design of thermally compensated, monolithic DASH interferometers.

Localized Provoked Vestibulodynia: Do Multiple Etiologic Triggers Manifest as Neurogenic Vulvar Pain? We propose that localized provoked vestibulodynia (LPV) results from diverse precipitating factors that ultimately establish and maintain neurogenic pain responses. An immune-cell–mediated inflammatory cascade may be the common mechanism through which various triggers establish neurogenic vulvar pain. Distinct etiologies of localized provoked vestibulodynia that manifest through neurogenic pain pathways may include its development subsequent to vulvovaginal infection, its comorbidity with and interstitial cystitis, and the role of sex hormones in triggering vestibulodynia. The medical history, the presence of genetic predisposing factors, the focal pattern and severity of vestibular pain, the pattern of subclinical inflammation along genital tract, and the presence of immune cell mediators and neuronal hyperplasia may provide clues as to the underlying pathophysiology of this perplexing syndrome.

Advances in measuring devices have made it feasible to conveniently measure localized changes in skin temperature. A series of experiments were conducted to determine if the addition of surface skin temperature measurements into studies commonly used to screen for skin responses to consumer products would increase the ability to discriminate between similar, mild products. Three testing protocols were evaluated: the modified arm patch with 24-h occlusive exposure for 4 consecutive applications, the behind the knee (BTK) with 6-h occlusive exposures with pressure for 5 consecutive days, and the bikini area shaving study with assessments after manual shaving by women with self-reported irritation after using a manual razor. In the modified arm patch studies, the positive irritant control (0.1 % sodium lauryl sulfate) produced mean erythematous scores that were higher (p < 0.05) than reactions produced by the negative irritant control (0.9 % saline), or the mild products. The skin surface temperatures were not significantly different in any arm patch study. In the BTK the two mild products produced significantly different levels of erythema at both the afternoon scoring (30–60 min after sample removal) and the morning scoring (after approximately 18 h of recovery). Skin surface temperatures differed only at the morning scoring. In the bikini area shaving study, mean erythema after 48 h was lower (p < 0.05) than after 5 min or 24 h on the left side only, indicating some degree of handedness. Skin surface temperature was significantly higher prior to the shaving exercise than at any of the subsequent scoring time points. Results indicate that the addition of measurements of skin surface temperature using DermaTemp® to standard exposure protocols used to evaluate potential skin responses to consumer products would not increase the ability to discriminate between products.