The pros and cons of getting engaged in an online social community embedded within digital cognitive behavioral therapy for insomnia: survey among users

Background: Sleepio is a proven digital sleep improvement programme based on cognitive behavioural therapy (CBT) techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums and personal message walls. Objective: The aims of this study were to (1) explore the reasons for deciding to engage with the Sleepio online community, (2) explore the potential benefits arising from engagement with the online community, (3) identify and describe any problematic issues related to use of the online community. Methods: In total, 100 respondents (70% female; mean age 51, range 26-82 years) completed the online survey. Most respondents had started Sleepio with chronic sleep problems (59% to to 10 years, 35% >10years), and had actively engaged with the online community (85% had made a discussion or wall post). At the time of the survey, respondents had used Sleepio for a median of 12 weeks (range from 3 weeks to 2 years). Results: Responses to the open-ended questions were analysed using thematic analysis. This analysis revealed five initial drivers for engagement including: 1) the desire to connect with people facing similar issues; 2) seeking personalised advice; 3) curiosity; 4) being invited by other members; and 5) wanting to use all available sleep improvement tools. Advantages of engagement included: access to continuous support, reduced sense of isolation, being part of a non-judgmental community, personalised advice, positive comparisons with others, encouragement to keep going, and altruism. Five potential disadvantages were: design and navigation issues, uncertain quality of user-generated content, negative comparisons with others, excessive time commitments, and data privacy concerns. Participants related their community experiences to engagement with the Sleepio programme with the many stating it had supported their efforts to achieve sleep improvement, as well as helping with adherence and commitment to the programme. Conclusions: Despite some concerns, members regarded the Sleepio community as a valuable resource. Online communities may be a useful means through which to support long-term engagement with online therapy for insomnia

The long path to pregnancy: early experience with dual anonymous gamete donation in a European in vitro fertilisation referral centre

<p>Abstract</p> <p>Background</p> <p>This investigation describes features of patients undergoing in vitro fertilisation (IVF) and embryo transfer (ET) where both gametes were obtained from anonymous donors.</p> <p>Methods</p> <p>Gamete unsuitability or loss was confirmed in both members of seven otherwise healthy couples presenting for reproductive endocrinology consultation over a 12-month interval in Ireland. IVF was undertaken with fresh oocytes provided by anonymous donors in Ukraine; frozen sperm (anonymous donor) was obtained from a licensed tissue establishment. For recipients, saline-enhanced sonography was used to assess intrauterine contour with endometrial preparation via transdermal estrogen.</p> <p>Results</p> <p>Among commissioning couples, mean±SD female and male age was 41.9 ± 3.7 and 44.6 ± 3.5 yrs, respectively. During this period, female age for non dual anonymous gamete donation IVF patients was 37.9 ± 3 yrs (<it>p </it>< 0.001). Infertility duration was ≥3 yrs for couples enrolling in dual gamete donation, and each had ≥2 prior failed fertility treatments using native oocytes. All seven recipient couples proceeded to embryo transfer, although one patient had two transfers. Clinical pregnancy was achieved for 5/7 (71.4%) patients. Non-transferred cryopreserved embryos were available for all seven couples.</p> <p>Conclusions</p> <p>Mean age of females undergoing dual anonymous donor gamete donation with IVF is significantly higher than the background IVF patient population. Even when neither partner is able to contribute any gametes for IVF, the clinical pregnancy rate per transfer can be satisfactory if both anonymous egg and sperm donation are used concurrently. Our report emphasises the role of pre-treatment counselling in dual anonymous gamete donation, and presents a coordinated screening and treatment approach in IVF where this option may be contemplated.</p

Faith in ruins: fragments and pattern in the late works of Rose Macaulay

No abstract available