Die Schwangerschaft in der psychoanalytischen Ausbildung

Im vorliegenden Beitrag wird der Frage nachgegangen, inwiefern die eigene Schwangerschaft während der psychoanalytischen oder psychoanalytisch orientierten Ausbildung besonders herausfordernd und belastend ist. Trotz einer Zunahme der Präsenz der Thematik in Publikationen und an Weiterbildungsinstituten scheint dennoch ein Mangel an Informationen zur und Reflexion über die Situation der schwangeren Ausbildungskandidatin vorhanden zu sein. Um der Frage nach möglichen Gründen für den Mangel an Informationen und unzureichende Reflexion nachzugehen, wurden Gruppengespräche mit Frauen geführt, die während der Ausbildung schwanger wurden. Daraus wurden bedeutsame Aspekte herausgegriffen und als Themenblöcke zusammengefasst, diskutiert und in grössere, u. a. gesellschaftliche Zusammenhänge eingeordnet

Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation

Objectives: The aim of this study was to assess the maternal and neonatal outcome in patients with preterm premature rupture of membranes between 22 to 37 weeks of gestation in comparison to preterm birth patients.  Material and methods: Group of PPROM patients consisted of 127 women, the control group counted 141 women who delivered prematurely. The control group was formed by matching patient with the same gestational age at delivery and neonatal birth weight to every woman from study group. In both groups speculum and ultrasound examinations were performed, microbiological swabs were taken. In unclear cases of PPROM tests detecting amniotic proteins, such as PAMG-1 or IGFBP-1, were performed. According to gestational age at delivery, neonates were divided into subgroups: extremely premature infants (< 27 weeks 6 days), moderate premature infants (from 28 weeks 0 days to 33 weeks 6 days), late premature infants (from 34 weeks 0 days to 37 weeks 0 days).  Results: In the study group, median gestational age of delivery was 34 weeks 1 day and the same in control group — 34 weeks and 5 days (p > 0.05). Parameters of inflammatory status were more often reported in the PPROM group than in the preterm birth group, even if they weren’t statistically significant (positive culture of cervical swab, increased leukocytosis, CRP above 5). The rate of neonate survival was similar in both groups (93.7% and 94.1%). Congenital infection was more often diagnosed in group of neonates from PPROM pregnancies than in neonates from control group; (36% and 21.2% respectively; p = 0.009).  Conclusions: Our research appears to be consistent with theory of inflammatory etiology of PPROM. Optimal management of infection in PPROM patients seems to be the most important in efforts to prolong pregnancy

Urinary Cortisol, Aggression, Dominance and Competition in Wild, West African Male Chimpanzees

High dominance status is associated with fitness benefits in many social mammals. Yet, attaining and maintaining a high social status often comes with elevated energetic costs. Dominance rank-related exposure to energetic and psychosocial stressors is predicted to vary depending on the type of breeding system, the means a high rank is acquired and maintained, and the stability of the dominance hierarchy. Using behavioral data and urinary cortisol levels, we investigated whether a high dominance rank is associated with elevated energetic costs in Taï male chimpanzees and whether the relationship between male dominance rank and cortisol levels varies between stable and unstable dominance periods. Additionally, we investigated potential sources of energetic and psychosocial stress linked to competition over dominance status and mating opportunities. We found that higher-ranking males gave more aggressions than lower-ranking males in stable and unstable dominance periods, but that dominance rank and urinary cortisol levels were not associated in either period. Urinary cortisol levels were higher in all males in unstable compared to stable dominance periods, whereas aggression rates showed the reversed pattern, with higher rates in stable periods. Our results indicate that dominance maintenance is not associated with elevated physiological stress for dominant Taï male chimpanzees, and that social instability exposed all males to psychosocial stress, despite lower rates of aggressive interactions. Overall, these findings suggest that male chimpanzees adjust competitive behavior to context dependent conditions, possibly by means of predictability of outcomes of social interactions, and use conflict management strategies, such as avoidance of aggression potentially diminishing the risk of escalation

Pandemic Stress and Its Correlates among Pregnant Women during the Second Wave of COVID-19 in Poland

The ongoing COVID-19 pandemic has created numerous stressful conditions, especially for vulnerable populations such as pregnant women. Pandemic-related pregnancy stress consists of two dimensions: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress), and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). The purpose of our study was to elucidate the association between various factors - sociodemographic, obstetric, pandemic-related, and situational - and pandemic stress in its two dimensions during the second wave of the COVID-19 pandemic in Polish pregnant women. Methods: A cross-sectional study with a total of 1119 pregnant women recruited during the second wave of the COVID-19 pandemic in Poland (between November 2020 and January 2021). Participants were recruited via social media to complete an online study questionnaire that included sociodemographic, obstetric, situational, and COVID-19 pandemic factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Results: Nearly 38.5% of participants reported high Preparedness Stress; 26% reported high Perinatal Infection Stress. Multivariate analyses indicated that lack of COVID-19 diagnosis, higher compliance with safety rules and restrictions, and limited access to outdoor space were independently associated with moderate to severe levels of Infection Stress. Current emotional or psychiatric problems, nulliparity, limited access to outdoor space, and alterations to obstetric visits were independently associated with moderate to severe Preparedness Stress. Conclusion: Study findings suggest that particular attention should be focused on the groups of pregnant women who are most vulnerable to pandemic-related stress and therefore may be more prone to adverse outcomes associated with prenatal stress

Consistency of Social Interactions in Sooty Mangabeys and Chimpanzees

Predictability of social interactions can be an important measure for the social complexity of an animal group. Predictability is partially dependent on how consistent interaction patterns are over time: does the behavior on 1 day explain the behavior on another? We developed a consistency measure that serves two functions: detecting which interaction types in a dataset are so inconsistent that including them in further analyses risks introducing unexplained error; and comparatively quantifying differences in consistency within and between animal groups. We applied the consistency measure to simulated data and field data for one group of sooty mangabeys (Cercocebus atys atys) and to groups of Western chimpanzees (Pan troglodytes verus) in the Taï National Park, Côte d'Ivoire, to test its properties and compare consistency across groups. The consistency measures successfully identified interaction types whose low internal consistency would likely create analytical problems. Species-level differences in consistency were less pronounced than differences within groups: in all groups, aggression and dominance interactions were the most consistent, followed by grooming; spatial proximity at different levels was much less consistent than directed interactions. Our consistency measure can facilitate decision making of researchers wondering whether to include interaction types in their analyses or social networks and allows us to compare interaction types within and between species regarding their predictability.Peer Reviewe

Infectious Causes of Acute and Chronic Sinusitis

Paranasal sinuses anatomy is paired in 4 parts which includes frontal, maxillary, ethmoid, and sphenoid. Their relevant function is to secrete mucous for moisture, humidify inspired air, impart vocal resonance, and act as shock absorber for intracranial contents. Retention of secretions in the nasal cavity and sinuses can cause inflammation of the mucosa of paranasal sinuses and lead to infection. Classification of sinusitis is based on duration of symptoms. Diagnosis can be achieved clinically, however other diagnosis modalities such as cultures or radiology can help to achieve accurate diagnosis. Depending on the etiology management can be supportive or pharmacological. In some cases, long term monitoring and prevention therapy may be required

Early maternal loss leads to short-but not long-term effects on diurnal cortisol slopes in wild chimpanzees

The biological embedding model (BEM) suggests that fitness costs of maternal loss arise when early-life experience embeds long-term alterations to hypothalamic-pituitary-adrenal (HPA) axis activity. Alternatively, the adaptive calibration model (ACM) regards physiological changes during ontogeny as short-term adaptations. Both models have been tested in humans but rarely in wild, long-lived animals. We assessed whether, as in humans, maternal loss had short-and long-term impacts on orphan wild chimpanzee urinary cortisol levels and diurnal urinary cortisol slopes, both indicative of HPA axis functioning. Immature chimpanzees recently orphaned and/or orphaned early in life had diurnal cortisol slopes reflecting heightened activation of the HPA axis. However, these effects appeared short-term, with no consistent differences between orphan and non-orphan cortisol profiles in mature males, suggesting stronger support for the ACM than the BEM in wild chimpan-zees. Compensatory mechanisms, such as adoption, may buffer against certain physiological effects of maternal loss in this species

Patterns of urinary cortisol levels during ontogeny appear population specific rather than species specific in wild chimpanzees and bonobos

Compared with most mammals, postnatal development in great apes is protracted, presenting both an extended period of phenotypic plasticity to environmental conditions and the potential for sustained mother-offspring and/or sibling conflict over resources. Comparisons of cortisol levels during ontogeny can reveal physiological plasticity to species or population specific socioecological factors and in turn how these factors might ameliorate or exaggerate mother-offspring and sibling conflict. Here, we examine developmental patterns of cortisol levels in two wild chimpanzee populations (Budongo and Taï), with two and three communities each, and one wild bonobo population (LuiKotale), with two communities. Both species have similar juvenile life histories. Nonetheless, we predicted that key differences in socioecological factors, such as feeding competition, would lead to interspecific variation in mother-offspring and sibling conflict and thus variation in ontogenetic cortisol patterns. We measured urinary cortisol levels in 1394 samples collected from 37 bonobos and 100 chimpanzees aged up to 12 years. The significant differences in age-related variation in cortisol levels appeared population specific rather than species specific. Both bonobos and Taï chimpanzees had comparatively stable and gradually increasing cortisol levels throughout development; Budongo chimpanzees experienced declining cortisol levels before increases in later ontogeny. These age-related population differences in cortisol patterns were not explained by mother-offspring or sibling conflict specifically; instead, the comparatively stable cortisol patterns of bonobos and Taï chimpanzees likely reflect a consistency in experience of competition and the social environment compared with Budongo chimpanzees, where mothers may adopt more variable strategies related to infanticide risk and resource availability. The clear population-level differences within chimpanzees highlight potential intraspecific flexibility in developmental processes in apes, suggesting the flexibility and diversity in rearing strategies seen in humans may have a deep evolutionary history.Publisher PDFPeer reviewe