The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate

BACKGROUND Psychological interventions for infertile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analysis was to examine if psychological interventions improve mental health and pregnancy rate among infertile patients. Thus, controlled studies were pooled investigating psychological interventions following the introduction of assisted reproductive treatments (ART). METHODS The databases of Medline, PsycINFO, PSYNDEX, Web of Science and the Cochrane Library were searched to identify relevant articles published between 1978 and 2007 (384 articles). Included were prospective intervention studies on infertile patients (women and men) receiving psychological interventions independent of actual medical treatment. The outcome measures were mental health and pregnancy rate. A total of 21 controlled studies were ultimately included in a meta-analysis comparing the efficacy of psychological interventions. Effect sizes (ES) were calculated for psychological measures and risk ratios (RR) for pregnancy rate. RESULTS The findings from controlled studies indicated no significant effect for psychological interventions regarding mental health (depression: ES 0.02, 99% CI: −0.19, 0.24; anxiety: ES 0.16, 99% CI: −0.10, 0.42; mental distress: ES 0.08, 99% CI: −0.10, 0.51). Nevertheless, there was evidence for the positive impact of psychological interventions on pregnancy rates (RR 1.42, 99% CI: 1.02, 1.96). Concerning pregnancy rates, significant effects for psychological interventions were only found for couples not receiving ART. CONCLUSIONS Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatmen

The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate

BACKGROUND: Psychological interventions for infertile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analysis was to examine if psychological interventions improve mental health and pregnancy rate among infertile patients. Thus, controlled studies were pooled investigating psychological interventions following the introduction of assisted reproductive treatments (ART). METHODS: The databases of Medline, PsycINFO, PSYNDEX, Web of Science and the Cochrane Library were searched to identify relevant articles published between 1978 and 2007 (384 articles). Included were prospective intervention studies on infertile patients (women and men) receiving psychological interventions independent of actual medical treatment. The outcome measures were mental health and pregnancy rate. A total of 21 controlled studies were ultimately included in a meta-analysis comparing the efficacy of psychological interventions. Effect sizes (ES) were calculated for psychological measures and risk ratios (RR) for pregnancy rate. RESULTS: The findings from controlled studies indicated no significant effect for psychological interventions regarding mental health (depression: ES 0.02, 99% CI: -0.19, 0.24; anxiety: ES 0.16, 99% CI: -0.10, 0.42; mental distress: ES 0.08, 99% CI: -0.10, 0.51). Nevertheless, there was evidence for the positive impact of psychological interventions on pregnancy rates (RR 1.42, 99% CI: 1.02, 1.96). Concerning pregnancy rates, significant effects for psychological interventions were only found for couples not receiving ART. CONCLUSIONS: Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment

Association between drug intake and incidence of malignancies in patients with Juvenile Idiopathic Arthritis: a nested case-control study

Background: Several medications for treatment of Juvenile Idiopathic Arthritis (JIA) are considered to be carcinogenic. Therefore, the aim was to assess whether there is an association between therapeutic interventions and malignancies in JIA patients. Findings: A nested case-control study was carried out within a retrospective cohort study of 3698 JIA patients diagnosed between 1952 and 2010. All 48 JIA patients with a diagnosis of a malignant tumour and up to four matched controls for each received a questionnaire about their use of medication. Subsequently treatment was compared between cases and controls and analyses performed for 37 cases and 125 controls (response 88.5 %). Treatment with DMARD (84 %) was most frequently used, followed by glucocorticoids (66 %) and immunosuppressives (65 %). Twenty percent reported to have ever been taking biologics. Medication use did not differ significantly between cases and controls. Conclusions: Our results did not show an association between medications used and malignancies in JIA patients

Professionalization of student teachers for inclusive science teaching

Durch die Ratifizierung der UN-Behindertenrechtskonvention (United Nations 2006, Artikel 24) hat sich Deutschland verpflichtet »Bildung für alle« (UNESCO 2015) im deutschen Schulsystem möglich zu machen. In der Lehrer*innenbildung stellen sich zwei Herausforderungen für die Fachdidaktiken: Erstens ist der Schulunterricht in verschiedene Fächer aufgegliedert, die jeweils eigene Fachinhalte aufweisen. Diese Inhalte müssen entlang fachdidaktischer Prinzipien inklusiv aufbereitet werden. Zweitens steigt die Komplexität der Fachinhalte vom Übergang der Grundschule in die Sekundarstufe deutlich an, sodass es für Lehrkräfte immer schwieriger wird, auf heterogene Lernvoraussetzungen angemessen einzugehen (Musenberg und Riegert 2015, 5). Die Professionalisierung von Lehrkräften muss gezielt auf diese Herausforderungen reagieren und Lehramtsstudierende nachhaltig auf ihr Tätigkeitsfeld vorbereiten. Wie diese Professionalisierung von Lehramtsstudierenden in Forschung und Lehre umgesetzt werden kann, wird exemplarisch an einem Projektseminar zum inklusiven naturwissenschaftlichen Unterricht vorgestellt. Das BMBF Projekt »Nawi-In« vereint Forschung und Lehre, indem es die Kompetenzentwicklung Studierender im Projektseminar beforscht. Dies wird durch videobasierte Kompetenzforschung begleitet (Riegel 2013).Germany ratified the UN Convention on the Rights of Persons with Disabilities (United Nations 2006, Article 24), and is therefore bound by contract to make »Education for All« possible (UNESCO 2015) in the German school system. Now there are two challenges for science education: first, the school education is divided in different subjects with different subject contents. The contents have to be prepared inclusively and subject-related. Second, the complexity of the subject contents rises noticeably from primary to secondary school, so it gets more difficult to regard all needs of a heterogeneous group of students adequately (Musenberg and Riegert 2015, 5). Therefore, a professionalization of teacher students should target these challenges to prepare them effectively for their working field. How the implementation of teacher students’ professionalization can be orchestrated is shown exemplary by a project seminar designed for inclusive science teaching. Research and teaching is united through the »Nawi-In«-project – funded by the Federal Ministry of Education and Research – by investigating the students’ development of competencies. This development is monitored by video-based competency research (Riegel 2013)

App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial

Background: Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective: The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods: Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results: We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions: The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques

Developing an Awareness Campaign to Reduce Second Hand Smoke Among Disadvantaged FamiliesA Participatory M-Health Approach

Children from disadvantaged families are particularly exposed to second hand smoke in their home environment. Using a mixed methods participatory approach, we aimed at identifying suitable media channels and appropriate content for a campaign increasing caregivers' knowledge about the risks of second hand smoke (SHS) exposure for their children and appropriate measures for exposure reduction. In the first phase of the mixed method design, we evaluated knowledge and norms about children's SHS and perceived barriers for avoiding it. To this end, we conducted 26 one-to-one interviews with smoking caregivers of children below the age of six years. Subsequently, we developed and illustrated core messages and identified appropriate communication channels. These were evaluated in focus group discussions by 20 of the 26 interview participants. After a final revision, 121 caregivers evaluated the campaign via an online questionnaire. Online social networks were identified as the most suitable media channel. For these, we developed animated photos with voiceovers addressing the potential consequences of SHS for children. The overall rating of the campaign messages was promising. Participants confirmed that it was important to address the issue in social media. However, sharing the pictures was considered unlikely due to the sensitive topic of the campaign, while the importance of doctors or scientists being recognizable as a source was highlighted. Employing a participatory approach, we developed an m-health campaign, which can now be disseminated in social networks to reach the target population. The effectiveness of the campaign should be evaluated

Education and employment in patients with juvenile idiopathic arthritis - a standardized comparison to the German general population

Background: Although several studies show that JIA-patients have significantly lower employment rates than the general population, the research on educational and occupational attainments in patients with juvenile idiopathic arthritis (JIA) remain conflicting most likely due to small sample sizes. Therefore, aim of this study is to compare the educational achievements and employment status of 3698 JIA-patients with the German general population (GGP). Methods: "SEPIA" was a large cross-sectional study on the current status of a historic cohort of JIA-patients treated in a single center between 1952 and 2010. For the analyses of education and employment a sub-cohort was extracted, including only adult cases with a confirmed diagnosis of JIA (N = 2696). Participants were asked to fill out a standardized written questionnaire on education and employment. Outcome measures (education/unemployment) were directly standardized to the GGP using data obtained from the National Educational Panel Study 2013 (N = 11,728) and the German Unemployment Statistics 2012 of the Federal Statistical Office (N = 42,791,000). Results: After age-and sex-standardization, 3% (95% Confidence Interval 1.9 to 4.1%) more of the JIA-patients (26%) than of the GGP (23%) had only reached primary education. In contrast, parents of JIA-patients had similar levels of education as parents in the GGP. With a standardized difference of 0.2% (95% CI: 0.16 to 0.19%), the unemployment rate in JIA-patients was slightly, but not significantly higher than in the GGP. Stratifying for disease duration and the current treatment status, differences were confirmed for persons diagnosed before 2001, whilst for patients diagnosed after 2000, differences were found only in JIA-patients with ongoing disease. Medium and high educational achievements did not differ statistically significant between JIA patients and the GPP. Conclusion: Educational achievements in German JIA-patients are significantly lower than in the GGP. Furthermore we were able to identify a slightly higher level of unemployment, especially in those with still under treatment and longer disease duration. Better treatment options as well as further development of social support programs might help to overcome this lifelong secondary effect of JIA

Enabling Technologies for Silicon Microstrip Tracking Detectors at the HL-LHC

While the tracking detectors of the ATLAS and CMS experiments have shown excellent performance in Run 1 of LHC data taking, and are expected to continue to do so during LHC operation at design luminosity, both experiments will have to exchange their tracking systems when the LHC is upgraded to the high-luminosity LHC (HL-LHC) around the year 2024. The new tracking systems need to operate in an environment in which both the hit densities and the radiation damage will be about an order of magnitude higher than today. In addition, the new trackers need to contribute to the first level trigger in order to maintain a high data-taking efficiency for the interesting processes. Novel detector technologies have to be developed to meet these very challenging goals. The German groups active in the upgrades of the ATLAS and CMS tracking systems have formed a collaborative "Project on Enabling Technologies for Silicon Microstrip Tracking Detectors at the HL-LHC" (PETTL), which was supported by the Helmholtz Alliance "Physics at the Terascale" during the years 2013 and 2014. The aim of the project was to share experience and to work together on key areas of mutual interest during the R&D phase of these upgrades. The project concentrated on five areas, namely exchange of experience, radiation hardness of silicon sensors, low mass system design, automated precision assembly procedures, and irradiations. This report summarizes the main achievements

Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients

Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs.Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly =stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32-14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19-0.95, p = 0.037) predicted longer OS.Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes