Understanding and Treating the Psychosocial Consequences of Infertility

Psychological distress and infertility are linked in a complex pattern, such that distress may be a cause of infertility and reduce the probability of achieving a pregnancy at the same time that infertility may be a cause of psychological distress. Although infertile women are not more likely to be characterized by psychopathology, they are more likely to experience higher levels of distress than comparison groups. Infertile men also experience psychological distress, but women experience more infertility distress than men. Both infertility and its treatment are stressors putting a heavy psychological strain on couple relationships. Whereas there is general agreement about the need for psychological interventions to treat infertility distress, little is known about the efficacy and effectiveness of psychosocial intervention. Given the prevalence of infertility and the fact that the numbers of individuals and couples seeking infertility treatments are increasing, it is essential that mental health professionals understand the emotional challenges faced by this population.https://digitalcommons.chapman.edu/mft_books/1002/thumbnail.jp

Measuring mitochondrial respiration in vivo: From mouse to human

Introduction: The mitochondrial energy ecosystem can be non-invasively interrogated in photoreceptors by combing a clinical tool, optical coherence tomography (OCT), with a mitochondrial protonophore (2,4 dinitrophenol, DNP). It remains unclear if only supra-clinical doses of DNP will be useful for mouse studies or if lower but clinically relevant doses of DNP would facilitate translation from mice to humans. Methods: The experiment was a paired longitudinal design that took place over 2 days. On day 1, C57BL/6J mice were overnight dark adapted, then light-adapted for 5 h before OCT examination before regaining consciousness; a similar procedure was followed on day 2 but mice were injected IP with either saline or an acceptable human dose of DNP (0.5 mg/kg) 1 hour before OCT examination. Pre- and post-injection retinal laminae thickness were compared for evidence of toxicity. In particular, we measured the external limiting membrane – retinal pigment epithelium to look for thinning between day 1 and 2, which has a confirmed basis in DNP modulation of rod photoreceptor mitochondrial respiration upstream based on pH-triggering of RPE co-transporter-based water efflux. Results: Compared to uninjected controls, saline evoked no changes in retina layer thickness between days 1 and 2. On the other hand, a clinical dose of DNP caused a reduction in ELM-RPE thickness in the absence of any other changes in retinal layer thickness, a finding consistent with increased mitochondrial respiration. Conclusions: The promising results herein raise the possibility that combining a low dose of DNP with a standard clinical imaging tool will facilitate first-in-kind measurements of neuronal mitochondria in patients suffering from a range of diseases and morbidities

Higher Education and Society: A research report

This report draws on a substantial body of research undertaken by the Open University's Centre for Higher Education Research and Information (CHERI) on the changing relationships between higher education and society. Higher education currently faces many changes, some externally driven by government policies and changing patterns of social and economic demand and some internally driven by changes in the way knowledge is produced and organised within universities and other 'knowledge organisations'. CHERI examines these changes through empirical research which is policy relevant though not policy dictated, frequently international, and broadly focused on the social impacts of higher education. Does higher education make a difference and to whom? In their different ways, the articles in this report seek to provide answers to this important but difficult question

Resource utilisation and cost of ambulatory HIV care in a regional HIV centre in Ireland: a micro-costing study

BACKGROUND: It is anticipated that demands on ambulatory HIV services will increase in coming years as a consequence of the increased life expectancy of HIV patients on highly active anti-retroviral therapy (HAART). Accurate cost data are needed to enable evidence based policy decisions be made about new models of service delivery, new technologies and new medications. METHODS: A micro-costing study was carried out in an HIV outpatient clinic in a single regional centre in the south of Ireland. The costs of individual appointment types were estimated based on staff grade and time. Hospital resources used by HIV patients who attended the ambulatory care service in 2012 were identified and extracted from existing hospital systems. Associations between patient characteristics and costs per patient month, in 2012 euros, were examined using univariate and multivariate analyses. RESULTS: The average cost of providing ambulatory HIV care was found to be €973 (95% confidence interval €938 - €1008) per patient month in 2012. Sensitivity analysis, varying the base-case staff time estimates by 20% and diagnostic testing costs by 60%, estimated the average cost to vary from a low of €927 per patient month to a high of €1019 per patient month. The vast majority of costs were due to the cost of HAART. Women were found to have significantly higher HAART costs per patient month while patients over 50 years of age had significantly lower HAART costs using multivariate analysis. CONCLUSIONS: This study provides the estimated cost of ambulatory care in a regional HIV centre in Ireland. These data are valuable for planning services at a local level, and the identification of patient factors, such as age and gender, associated with resource use is of interest both nationally and internationally for the long-term planning of HIV care provision

Less time to study, less well prepared for work, yet satisfied with higher education: A UK perspective on links between higher education and the labour market

This paper explores graduates’ views on the relationship between higher education and employment. It draws on a major European study involving graduates five years after graduation and highlights similarities and differences between UK graduates’ experiences and their European counterparts. Specifically we address questions raised in the study about subjects studied and their relevance to entry into the labour market, if the academic level obtained was appropriate, whether graduates, with hindsight of five years, would choose the same subjects or the same institution again, and if they were satisfied with their current job. Such specific questions relate to broader perspectives such as the perceived value of higher education study in relation to initial employment and future life histories. These have to be seen in the context of cultural differences in higher education systems at the time of the research and, perhaps increasing convergences in light of the Bologna agreement

Employer and higher education perspectives on graduates in the knowledge society

The research on which this report is based was part of a larger international project on ‘The Flexible Professional in the Knowledge Society’ (the ‘REFLEX’ project) funded by the European Commission Framework VI Programme. There were three elements to this project: a survey of higher education graduates five years after they had completed their first degree courses; a series of country reports providing contextual information on national higher education systems and labour markets; a qualitative study of the perspectives of employers of graduates and university leaders. This report sets out the findings of this third element of the REFLEX project. The aim of the qualitative element of the project was to investigate the expectations and experiences of employers and university leaders regarding the kinds of knowledge, skills and competences that are required of graduates in the ‘knowledge society’, the extent to which these requirements are being met and the kinds of changes that are needed in order to achieve a better match between the requirements of employment and the outputs of higher education. The focus was on the kind of changes that are felt necessary in higher education institutions and in employment organisations in order to achieve a better match between higher education’s output and the demands of working life. Key questions were: • What competences do employers expect of their graduate workers? • What role is ascribed to higher education providers in producing them? • How do higher education institutions see their responsibility for the employability of their graduates? • What initiatives do they take to discharge these responsibilities? The study involved five countries: Norway, the UK, Germany, The Netherlands and France. Most field work was undertaken in the period April –July, 2005

The context of higher education and employment: comparisons between different European countries. REFLEX Report to HEFCE No 2 (uses data gathered for a major international study of graduate employment five years after graduation)

This second report in the series provides contextual information on the participating countries in the REFLEX project. Topics covered include the different histories and traditions of higher education, the characteristics of the higher education systems, as well as information on the national labour markets and the differences in the role of higher education in recruitment and preparation for the labour market. The information is intended to be used in relation to the other reports in the series, helping in the interpretation of country differences in the employment experiences of graduate

Interferon-stimulated gene (ISG)-expression screening reveals the specific antibunyaviral activity of ISG20

Bunyaviruses pose a significant threat to human health, prosperity and food security. In response to viral infections, interferons (IFNs) upregulate the expression of hundreds of interferon stimulated genes (ISGs) whose cumulative action can potently inhibit the replication of bunyaviruses. We used a flow cytometry-based method to screen the ability of ∼500 unique ISGs from humans and rhesus macaques to inhibit the replication of Bunyamwera orthobunyavirus (BUNV), the prototype of both the Peribunyaviridae family and Bunyavirales order. Candidates possessing antibunyaviral activity were further examined using a panel of divergent bunyaviruses. Interestingly, one candidate, ISG20, exhibited potent antibunyaviral activity against most viruses examined from the Peribunyaviridae, Hantaviridae and Nairoviridae families, whereas phleboviruses (Phenuiviridae) largely escaped inhibition. Similar to other viruses known to be targeted by ISG20, the antibunyaviral activity of ISG20 is dependent upon its functional ribonuclease activity. Through use of an infectious VLP assay (based on the BUNV minigenome system), we confirmed that gene expression from all 3 viral segments is strongly inhibited by ISG20. Using in vitro evolution, we generated a substantially ISG20-resistant BUNV and mapped the determinants of ISG20 sensitivity/resistance. Taken together, we report that ISG20 is a broad and potent antibunyaviral factor yet some bunyaviruses are remarkably ISG20 resistant. Thus, ISG20 sensitivity/resistance could influence the pathogenesis of bunyaviruses, many of which are emerging viruses of clinical or veterinary significance

The potential synergistic behaviour of inter- and intra-genus probiotic combinations in the pattern and rate of short chain fatty acids formation during fibre fermentation

This study compared the rate of short chain fatty acid (SCFA) production by different probiotic combinations of Lactobacillus and Bifidobacterium to determine any synergistic effects. Six different fibre fractions were fermented with nine combinations of Lactobacillus rhamnosus (LR), Lactobacillus acidophilus (LA), Bifidobacterium longum (BL) and Bifidobacterium breve (BB) for 0, 6, 24 and 48 h. SCFAs were quantified by gas chromatography. Inter-genus combinations of bacteria produced more SCFA, especially BB + BL + LR, compared to intra-genus that yielded the lowest SCFA production. Acetate was the most abundant, while propionate and butyrate were the most utilised. The SCFA formation was as acetate \u3e propionate \u3e butyrate and the total dietary fibre produced most of the SCFA. Most combinations utilised 60–80% of the fibre; BB + BL + LR digested the fibre completely. The quantity, pattern and the time of release of SCFA depends on the genus, but the combination of pre and probiotics is of great importance for the outcome