Day Care Settings Research Articles

The effect of high vs. low intensity neuropsychological treatment on working memory in patients with acquired brain injury

ABSTRACT Aim To evaluate the combined effect of compensation therapy and functional training on working memory (WM) in patients with acquired injury and chronic cognitive deficits by investigating the dose-response relationship and specificity of transfer effects. Research design Double-blind randomized controlled trial. Methods All patients underwent 4 weeks of compensation therapy in a day-care setting. In addition, they received either 20 sessions of computer-based WM training (n = 11) or attention training (n = 9). Transfer effects on cognition and their functional relevance in daily life were assessed before treatment, after 2 weeks (10 additional training sessions), and after 4 weeks (20 additional training sessions) of therapy. Results The combined treatment led to significant improvements in WM performance, verbal memory, and self-reported changes in daily life. The amount of training was identified to modulate efficacy: Significant improvements showed only in the later training phase. We observed no differences between the two training schemes (WM vs. attentional training). Conclusions Even in the chronic phase after brain lesion WM performance can be enhanced by the combination of compensation therapy and computerized cognitive training when applied intensely; both a more general attention and a specific WM training regimen are effective.

European Academy of Neurology guideline on the management of medication-overuse headache.

The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH). Based on the available literature in this guideline, the first step in patient management is education and counselling. Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and behavioral psychologists. Patients in whom education is not effective should be withdrawn from overused drugs and should receive preventive treatment with drugs of proven efficacy. Patients with MOH in whom preventive treatment is not effective should undergo drug withdrawal. Drug intake can be abruptly terminated or restricted in patients overusing simple analgesics, ergots or triptan medication. In patients with long-lasting abuse of opioids, barbiturates or tranquilizers, slow tapering of these drugs is recommended. Withdrawal can be performed on an outpatient basis or in a daycare or inpatient setting.

Clinical investigation on the analogy between the ketofol (Amalgamation of Ketamine and Propofol) and ketamine and midazolam for procedural sedation – A single blinded study

Decades of research for an ideal sedative agent that could provide both sedation and analgesia with minimal side effects to the patients has failed to find one. Research was then shifted to finding combination of drugs which could suffice the ideal sedative agent. Of these Ketofol showed promising results.Aim of this study is to “Assess the efficacy and safety of propofol and ketamine amalgamation (ketofol) and comparing the superiority over ketamine and midazolam combination for procedural sedation”. In this prospective randomized single blind study, 50 patients between 15 to 60 years of both males and females, ASA Grade I and Grade II were allocated into two groups. Patients in group 1 received ketofol and group 2 patients received ketamine and midazolam. The comparison between the two groups was done using Two-Sample T-Test, With the help of SPSS version 15.0 Statistical calculator, sample size calculated = 5 to 17, and actual power calculated with this sample size was 0.990 to 0.997 which shows significance of the study.: The study showed statistically significant (p <0.005) difference in HR, DBP, SBP, MBP and recovery time between two groups. Group 1 patients showed stabilized parameters and rapid recovery time than group 2 patients Ketofol is safe and efficient sedative combination which can be utilized in emergency department, daycare and OT settings with comfort, ease and without any complications. It is close to ideal sedative agent.

A comparison of child development, growth and illness in home-care and day-care center settings

PurposeChildcare is an essential part of early life environment that has a significant influence on lifelong physical and mental health. This study aimed to examine the relationship between development, growth and frequency of illness in different types of care.Design/methodology/approachThis cross-sectional study recruited 177 children aged 30–36 months and their caregivers. Of these 66 were being cared for at home and 111 were attending out-of-home day-care facilities. An interview form, growth measurement and the Denver Developmental Screening Test II were collected. The association between child developmental, growth and illness variables was analyzed with Chi-square, Fisher's exact and Mann–Whitney U tests.FindingsThis study found that the development and growth results did not show statistically significant differences between the home-care and day-care groups. The number of minor illnesses was significantly lower in home-care children than in day-care children (OR = 0.33, 95% CI = 0.15-0.72).Research limitations/implicationsThis study indicated that the risk of infection is increased in the children attending day care. Provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.Originality/valueAs the number of women's participation in the labor market has increased rapidly over the past decades, so did the number of children in nonparental care. The study findings reflect that the development of a day-care center for children was unclear, whereas the risk of infection was increased. Therefore, provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

Verbal and Behavioral Expressions of Child Sexuality Among 1–6-Year-Olds as Observed by Daycare Professionals in Finland

A safe childhood respecting sexual rights forms the foundation of an individual's sexual health. However, the understanding, support, and protection of early sexuality are seldom discussed. Children already express their sexuality verbally and behaviorally in daycare, often requiring a response from staff. These day-to-day situations may have an influence on children's later sexuality. The World Health Organization Regional Office for Europe and BZgA (2010) published a framework for professionals on age-appropriate, holistic sexuality education. Using this framework, we evaluated children's sexuality-related expressions in Finnish daycare. Ournationwide questionnaire among professionals in early childhood education and care (n = 507) focused on how 1-6-year-old children expressed their sexuality in their speech and behavior. All eight topics in the WHO framework emerged regularly. The two most prevalent topics were the body and emotions. Also, 71% of professionals had a child in their group who masturbated openly. Early sexual development manifested as curiosity about one's own body, exploring its functions, traits, and attributes, while on an emotional level it manifested as abundant feelings of infatuation and tenderness, shown openly toward those-peers and adults alike-whom the child cares for. Childhood sexuality is broadly and diversely present in children's verbal and behavioral expressions in daycare settings. Children need and have the right to receive explicit responses related to issues concerning their sexual development and to receive age-appropriate information, skills, and attitudes fostering healthy development.

Distracted Daycare and Child Welfare: An Ethical Analysis

ABSTRACT Parental overuse of portable technology poses a bonafide threat to the welfare and development of children. In the past decade, researchers have documented this phenomenon whereby parents pay far more attention to handheld electronic devices than to their children's safety and developmental needs. What most studies have failed to examine is the extent to which workers in privately owned and operated daycares also exhibit technology-induced distracted behavior. This article aims to identify the moral harm of caregivers' distracted behaviour in a private daycare setting or, more simply, the welfare effects of distracted daycare. First, with the assistance of recent research, the phenomenon of distracted caregiving is defined. Then, the documented harms of distracted caregiving in a daycare setting are catalogued. Next, an ethical analysis of the phenomenon of distracted daycare working is undertaken from four normative ethical perspectives: (i) ethical egoism, (ii) utilitarianism, (iii) principlism and (iv) care ethics. Five recommendations for reforming distracted daycares, each based upon one or more of the four ethical perspectives, inform the article's conclusions.

Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

The purpose of the study was to evaluate the current clinical practice of Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation in German psychiatry. Case-based data (> 1.000.000 cases) were collected according to §21 of the German hospital remuneration law from January 2015 to December 2017. The study cohort comprises approximately 35–40% of the annual psychiatric cases and hospitals in Germany. Frequency of ECT and rTMS cases were investigated considering main diagnoses according to ICD-10 and treatment settings (inpatient vs. day-care). ECT cases with short-term hospitalization (≤ 4 days) were supposed to be maintenance ECT cases. A linear regression analysis was conducted to estimate trends in the use of ECT and rTMS. Different groups were compared using Chi-square tests. ECT and rTMS cases appear to increase in total during the observation period possibly due to facilities newly introducing ECT and rTMS but also to increased frequency of treatments. Both treatments were rarely performed in day-care settings (0.89% and 11.25%). ECT was performed in 1.72% of all cases with affective disorders and in 1.48% with major depressions, respectively. Age ≥ 65 years, females, severe and psychotic depression were significantly associated with a higher rate of ECT cases. > 40% of all ECT cases were possibly maintenance ECT cases. Only 0.60% of these were performed in day- care settings. rTMS was primarily performed in major depression (86,7% of all rTMS cases). This study suggests a growing demand for ECT and rTMS. Nevertheless, the use of ECT is still low compared to the high prevalence of treatment resistant depression. The use of rTMS is even lower and seems to be restricted to specialized institutions. Maintenance ECT is frequently carried out in an inpatient setting. Limitations of this study are the case- and group-based analysis, missing data on outpatient services and treatment sessions per case. Therefore, the database is not necessarily representative for the entire German healthcare system. Further studies are needed to verify the presented findings and should address the feasibility of ambulatory and day-care ECT services.

Diaper Dermatitis: Prevalence and Associated Factors in 2 University Daycare Centers.

Purpose: Diaper dermatitis is uncommon in children older than 2 years because the majority of these children are diaper independent. However, diaper dermatitis still occurs, especially in children in daycare settings. This study attempted to determine the prevalence of diaper dermatitis and its associated factors among children aged 2 to 4 years attending daycare centers. Cross-sectional analysis and tests for correlation were conducted to determine the factors associated with diaper dermatitis among the study population. Results: The prevalence of diaper dermatitis during the study period was 17.2%. Factors significantly correlated with the occurrence of diaper dermatitis were beginning toilet training later than 2 years of age (odds ratio [OR] = 2.84, 95% CI = 1.17-6.86, P = .02) and the use of oral antibiotics (OR = 15.92, 95%CI = 3.57-70.94, P < .001). Conclusion: Two major adjustable factors for preventing diaper dermatitis in the study population were toilet training before 2 years of age and avoiding the use of unnecessary oral antibiotics. These results may help in devising a preventive protocol for diaper dermatitis among this age group in the future.

Percutaneous endoscopic gastrostomy; success and outcome of a novel modality for enteral nutrition.

To determine the indications and complications of percutaneous endoscopic gastrostomy tube. The retrospective audit study was conducted at the Department of Gastroenterology, Endoscopy Unit, Patel Hospital, Karachi, and comprised data of patients aged 4-95 years who underwent placement of percutaneous endoscopic gastrostomy under conscious sedation and for patients under 18 years of age having obtained anaesthesia fitness, under general anaesthesia, from August, 2008, to July, 2018. Pre-procedure treatment and follow-up was noted on a structured proforma. Data analysed using SPSS 21. Of the 367 patients, 237(64.6%) were males and the overall mean age of the sample was 63±15 years. Of the total, 257(70%) procedures were done in the day-care setting. The most common primary indication for tube placement was neurological dysphagia 259(70.6%). No procedure-related mortality was observed, but 35(9.5%) patients had PEG-site infection, and 3(8.5%) of them required removal of the tube. Percutaneous endoscopic gastrostomy was found to be an effective and useful feeding alternative, leading to improved nutrition.

The Portable Psychoanalytic Frame: Evenly Suspended Attention, Bick’s Method of Infant Observation and Its [Unexpected] Application by an Observer in a Day Care

ABSTRACT This paper uses Freud’s idea of evenly suspended attention, as applied through Bick’s method of infant observation, to demonstrate a technique crucial to the work of the parent-infant clinician. Cultivating an evenly suspended state of attention is shown to be an indispensable technique for the clinician’s mind at work, especially for the parent infant clinician, whose external setting is unpredictable and challenging. Without a fixed external setting, a portable frame is required: the internal setting established by combining psychoanalytic theory with this specific kind of free-floating attention. This claim will be illustrated by an observer’s use of attentiveness in a daycare setting. The observer gathered the experience of a four-month-old infant in psychic peril. Lacking his caregiver’s attention, the infant was object-absent. The observer’s sensitive, absorbing stance was pivotal: not only to finding meaning and containing the primitive anxieties of an infant in trouble, but also – critically – to enabling the development of the infant’s sense of self by building a mental bridge to an unavailable caregiver, who could be reached and ultimately found a place in her mind for him.

Interdisciplinary Identification of Preschooler Developmental Status, Interventions and Monitoring in the Preschool System in Israel

A unique program was designed for interdisciplinary interventions in regular daycare settings in Israel in order to identify and treat, in their natural environments, preschoolers aged 3-6 with developmental delays. Evaluations determine developmental status in speech, motor skills, emotional health, sleep hygiene, nutritional status, and more. Progress is monitored over two years. Educational staff and parents are an integral part of the program; the former acquire skills that promote sustainability of the project, and parents learn skills that benefit all their children. The background and development of the program, the rationale for its various elements and its implementation are discussed. This program may be of particular significance where there is a high concentration of immigrant or refugee populations.

A study of Current Realities of the Progress Monitoring Plan in the IEPs for Young Children with Special Needs

개별화교육계획의 구성요소 중 하나인 평가계획은 목적과 목표의 성취를 판단하기 위한 체계적인 자료수집과 분석이 요구되는 역동적인 과정이다. 본 연구에서는 경기, 충청 지역의 교육기관과 보육기관을 중심으로 특수교육대상 유아를 위한 개별화교육계획을 수집하였고 총 50부에 대해 평가계획을 분석하여 그 실태를 알아보았다. 분석 결과는 다음과 같다. 첫째, 특수교육대상 유아를 위한 IEP는 목적과 목표의 개수가 지나치게 많았고 보육기관이 교육기관보다 유의미하게 많았다. 둘째, 목표에 대한 수행기준은 대부분 제시 하였으나 성취기준은 거의 제시하지 않았다. 셋째, 평가자는 거의 제시하지 않았으며, 평가 주기의 제시는 매우 낮은 수준이며, 평가 주기를 명시한 경우 월 간격의 평가 주기가 가장 많았다. 넷째, 제시된 평가 방법은 관찰, 포트폴리오 순으로 제시되었으나 평가방법을 제시하지 않은 경우도 많았다. 연구 결과에 따른 논의와 과제를 제시하였다.The purpose of the present study is to investigate the current realities 1) if the Individualized Education Program(IEP) goals and objectives are measurable and 2) progress monitoring plan of the IEPs for young children with special needs both in the early childhood education settings and daycare settings. The subjects of the study were IEPs for young children special needs from the early childhood education setting and daycare setting. The results of this study were as follows. First, the number of goals and objectives of the IEPs were significantly greater from the daycare settings than the early childhood education settings. Second, the mastery criteria were higher than the retention criteria in the IEP objectives both from the early childhood education settings and the daycare settings. Third, only few IEPs presented assessor and time interval for progress monitoring, monthly monitoring was higher among the IEPs that presented timeline for progress monitoring. Finally, among the methods for progress monitoring presented in the IEPs, observation and portfolio were used most. However, there were many IEPs that did not present which method would be used for progress monitoring.

Giardiasis: An Overview.

Giardiasis is an important cause of waterborne and foodborne diarrhea, daycare center outbreaks, and traveler's diarrhea. The study aimed to provide an update on the evaluation, diagnosis, and treatment of giardiasis. A PubMed search was completed in Clinical Queries using the key terms "giardiasis", "Giardia lamblia", "Giardia duodenalis" and "Giardia intestinalis". The search strategy included metaanalyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to the English literature. Patents were searched using the key term "giardiasis" from www.freepatentsonline.com. Giardiasis is caused by the protozoan parasite Giardia lamblia. The parasite is transmitted by the fecal-oral route, frequently through ingestion of contaminated water and food or person-to person transmission. Risk factors for infection include children in day-care settings, child-care workers, institutionalized individuals, travelers in endemic areas, ingestion of contaminated or recreational water, immunodeficiency, cystic fibrosis, and oral-anal sex. Approximately 50 to 75% of infected children are asymptomatic. Other children present acute or chronic diarrhea. Direct fluorescent antibody tests that detect intact organisms, enzyme immunoassays that detect soluble antigens, and multiplex real-time polymerase chain reaction assays that detect specific genes of the parasite in stool samples have improved sensitivity and specificity compared with microscopic examination of stool specimens for the detection of Giardia trophozoites or cysts. Drugs used in the treatment of symptomatic giardiasis are reviewed in this study. Moreover, recent patents related to the management of giardiasis are also discussed. Metronidazole, tinidazole, and nitazoxanide are drugs of choice. Resistance to common antigiardial drugs has increased in recent years, therefore, the search for new molecular targets for antigiardial drugs is urgently needed. In general, treatment of asymptomatic carriers is not recommended. Purification of water supply is an important preventive measure.

A Natural History of Repetition

The purpose of this study was to understand typically developing children’s repetitive behavior in a free-play, daycare setting. By studying repetition in a non-Montessori setting, we tested the assumption that repetition is a characteristic behavior of all young children and not limited to the Montessori environment. Although Maria Montessori identified repetition during her observations, there is little empirical evidence to support her claim: most research has considered repetition in terms of psychopathology. We collected naturalistic observational data on 31 3- to 6-year-old children for a total of 101 hours to investigate the frequency, contexts, and structure of repetitive bouts. Multilevel model results suggest the ubiquity of repetition, as all children in the study engaged in motor repetition. Furthermore, repetition occurred throughout all free-play activities (construction, animation, fantasy play, rough-and-tumble play, and undirected activity), although repetition was not equally distributed across activities. Motor repetition was not equal across ages either; younger children engaged in more motor repetition than did older children. To understand the structure of repetition, our study also looked at the length of repetition bouts, which ranged from 2 to 19 repetitions and averaged 2.86 repetitions per bout. This natural history of repetition is an influential starting point for understanding the role of repetition in development and is informative to both Montessori and non-Montessori early childhood educators.

Co-production as a driver of client satisfaction with public service organizations: an analysis of German day-care centres

ABSTRACT This paper investigates the effects of co-production on satisfaction with public service organizations (PSOs) in a day-care setting. Based on a survey of parents from Germany, this paper validates the effects of economic, political, and social participation on satisfaction and considers the level of information, person-organization fit, and structural quality as mediating variables. Mediation analysis shows significant and positive indirect effects of political and social co-production on satisfaction. In contrast, economic co-production has no effect on client satisfaction. Based on the findings and the study’s limitations, this paper delineates practical implications and avenues for future research.

Management of odontogenic infection in paediatric patients: a retrospective clinical study.

To investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital. A retrospective study (2013-2015) was carried out which involved retrieving relevant data from past records (manual/electronic) of paediatric patients (under 18-years-old) who presented with odontogenic infections to the Paediatric Dentistry and Oral and Maxillofacial clinic. Data collected was organised using descriptive statistics with SPSS version 12.0.1. A total of 153 patients were identified, of which 83.7% were managed as outpatients. Odontogenic infections were more common in females (52.9%) and preschool children (58.2%). The most cases were seen in 2014 and maximum number of cases per month was 12. Common presentations were pain (62.1%), intraoral swelling (37.9%) and spontaneous pus discharge from the tooth and/or surrounding tissues (67.3%) with higher involvement of primary right molars. Dental panoramic tomograph was the most common radiographic investigation done. Outpatients were commonly managed chairside with pulpal opening (46.1%) at the paediatric dental clinic and 7% underwent extraction under general anaesthesia in day-care setting. Inpatients were admitted for 3days on average and most commonly definitive care was extraction under local/general anaesthesia (68%). There were 22.7% outpatients and 72.0% inpatients who were prescribed antibiotics. Overall, treatment and medications prescribed adhered to current guidelines. There was a tendency to solely prescribe antibiotics in 8.6% of outpatients which is contrary to recommendations.

Nuclear medical imaging as part of dementia diagnostics in psychiatric day-care clinics and inpatient care settings.

Current guidelines support the use of nuclear medical imaging (NMI) techniques for differential diagnostics of certain cases of dementia. We aimed at studying the association between using NMI and the accuracy of dementia diagnoses. Additionally, we evaluated the effect of conducting NMI on the duration of hospital treatment. This study was based on data collected according to §21 of the German hospital remuneration law, including relevant diagnostic and procedural codes for NMI in dementia patients. In total, more than 7.2 million cases treated in German psychiatric and somatic hospitals between 2015 and 2017 were included. Associations between the frequency of NMI and the accuracy of dementia diagnoses in terms of specific vs. unspecific diagnostic codes were analyzed using Fischer's exact test. In total, 351,106 cases with a dementia diagnosis were encoded during the study period. NMI was performed in 1.03% or 0.15% of all patients with dementia in psychiatric or somatic clinics, respectively. In psychiatric clinics, the proportion of unspecific dementia diagnoses decreased from 20.86% in 2015 to 17.73% in 2017. NMI was mainly performed within psychiatric day-care settings. Interestingly, patients receiving NMI stayed shorter within day-care settings (8.1 ± 16.0days) compared to inpatient settings (38.3 ± 44.7days). Nuclear medical imaging is often performed in psychiatric day-care settings. Further studies are warranted to understand the predictive diagnostic value of NMI in dementia diagnosis compared with clinical, CSF and structural imaging in different healthcare settings.

Effect of assisted walking-movement in patients with genetic and acquired neuromuscular disorders with the motorised Innowalk device: an international case study meta-analysis.

People with physical disabilities (PD) suffer from consequences due to lack of physical activity and consequently, are at increased risk of chronic diseases. We aimed to evaluate the ability of a motorised assistive device for dynamic standing with weight-bearing in addition to standard state-of-the-art therapy to improve clinical outcome in a meta-analysis of available studies. A total of 11 studies were identified from different European countries analysing the effect of the dynamic device Innowalk. Raw data of nine studies were pooled including a total of 31 patients observed between 2009 and 2017. Standardised questionnaires and physical outcomes were examined in this exploratory meta-analysis. We recorded patients’ characteristics, duration, intensity, and location of usage as well as general clinical outcomes and improvement of passive range of motion (PROM). The analysed population consisted in 90% cases of patients younger than 18 years of age. Patients were severely disabled individuals (aged 8 (6–10) years; 58% male; 67% non-ambulatory, 86% cerebral palsy). A total of 94% used the Innowalk in a home-based or day-care setting. For nearly all individuals (94%), improvements were recorded for: walking or weight-bearing transfer (n = 13), control/strength of the trunk or head (n = 6), joint mobility (n = 14), sleep (n = 4 out of 6/67%), or muscle strength (n = 17), vital functions (n = 16), bowel function (n = 10), attention/orientation (n = 2). PROM of the hip (flexion, abduction, and adduction) significantly (p < 0.001 for multiple comparisons) increased after 1 month (p < 0.05 flexion, adduction) and further after 5 months (p < 0.05 each) in contrast (p < 0.05 each) to a control group with state-of-the-art therapy. Similarly, PROM showed a trend towards improvement in dorsal extension of the ankle (p = 0.07). In summary, this is the first report of a novel device with additional benefit to standard therapy for severe PD. These intriguing results warrant the planned prospective randomised controlled trial to prove the concept and mechanism of action of this device.

School Nursing Protocol for the Management of Human Bites.

Human biting is considered a common stage in pediatric infant growth and development. However, this stage is not considered appropriate once children enter group daycare and school settings, and such behavior can lead to injury, stress, and trauma for other students and staff. When biting occurs in the school setting, staff are often unprepared to respond appropriately, and may seek delayed care, if at all. The school nurse may also be ill-equipped to provide first aid and education if there are no standardized guidelines to follow. Having a protocol in place for human bite incidents in the school setting helps school nurses provide information to students, parents, and staff in a timely manner and assists them with following evidence-based practice. Accurate documentation of the incidents also allows school nurses to identify triggers and knowledge deficits, which can assist them in planning educational interventions and training in the school setting.

How cure rates drive patients' preference for urethral bulking agent or mid-urethral sling surgery as therapy for stress urinary incontinence.

To assess the patients' median-accepted threshold of cure rate for urethral bulking agent (UBA) treatment compared to mid-urethral sling (MUS) surgery for treatment of female stress urinary incontinence (SUI). Secondly, to determine the correlation between treatment trade-off point and patient characteristics. Women older than 18 years, with predominant SUI, seeking treatment, underwent a structured interview. The treatment trade-off point was determined in scenario one: UBA vs transobturator standard MUS surgery (SMUS) performed under general/spinal anesthesia with one-night hospital stay, and scenario 2: UBA compared to single-incision MUS surgery (SIMS) performed under local analgesia (with sedation) in a daycare setting. The treatment trade-off point was assessed by decreasing the cure rate of UBA from 85% to 10% with steps of 2% until the patient's treatment preference switched to SMUS/SIMS. One hundred and five patients were interviewed. Mean age was 52 years (SD, ±13.4). The median trade-off point for scenarios 1 and 2 was 79% (interquartile range [IQR]: 69, 85) and 85% (IQR: 71, 85), respectively. Patients with longer duration of SUI symptoms were willing to trade more efficacy to prefer UBA treatment. Patients with SUI are willing to trade a lower cure rate to prefer UBA over SMUS to avoid hospitalization and general anesthesia. When SIMS is performed in a daycare setting under local analgesia, the majority of patients with SUI are of the opinion that cure rates of UBA should be at least as high as SIMS to be worth considering. The treatment preference is not strongly correlated with the patients' characteristics.