Intranasal cold dry air is superior to histamine challenge in determining the presence and degree of nasal hyperreactivity in nonallergic noninfectious perennial rhinitis

The objective of the study was to compare cold dry air (CDA) and histamine in differentiating patients with nonallergic noninfectious perennial rhinitis (NANIPER) from control subjects. Nasal reactivity (nasal patency, mucus production, and sneezing) in 16 symptomatic nonsmoking patients with NANIPER and seven nonsmoking control subjects was measured with standardized CDA and histamine provocation series in a randomized crossover study. Intranasal CDA resulted in increased mucus production and nasal blockage in a dose-dependent manner in patients with NANIPER but not in control subjects. Sneezing did not occur. The reproducibility of CDA for patency and mucus production was good. Sen

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Women's adjustment trajectories during IVF and impact on mental health 11–17 years later

STUDY QUESTION Do patients present different adjustment trajectories during and after IVF treatment? SUMMARY ANSWER Most women show resilient trajectories during and after IVF treatment but 37% show temporary or chronic maladjustment during IVF and 10% are maladjusted 11–17 years after treatment. WHAT IS KNOWN ALREADY Research on patient psychosocial adjustment during treatment has contributed to identifying the most distressful stages of IVF treatment and profiling patients at risk for emotional maladjustment at these specific stages. This knowledge is currently driving the deliverance of psychosocial care at fertility clinics by tailoring it to patients' risk profiles and specific treatment stages. However, current care does not take into consideration how individuals adjust across the entire treatment pathway. This can be assessed by profiling individual adjustment trajectories. STUDY DESIGN, SIZE, DURATION A longitudinal cohort study with five assessment moments that combines data from two different studies, the STRESSIVF and OMEGA projects. Participants enrolled in the STRESSIVF study (started IVF in 1998–2000) were assessed before and after the first IVF treatment cycle and 6 months and 2.5 years after the last IVF cycle. A subset participated in the OMEGA project (started IVF in 1995–2000) and reported on their mental health 11–17 years after treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS Three hundred and forty-eight women participated in the STRESSIVF project and 108 of these in the OMEGA. Anxiety was measured with the State and Trait Anxiety Inventory, depression with the Beck Depression Inventory and mental health with the Mental Health Inventory. Latent class growth mixed modelling was carried out to identify distinct anxiety and depression trajectories over the four STRESSIVF study assessment moments. Multinominal logistic regressions were conducted to investigate predictors of trajectory membership, and stepwise linear regressions were performed to investigate if adjustment trajectories predicted mental health 11–17 years after IVF treatment. MAIN RESULTS AND THE ROLE OF CHANCE A total of 67 and 86% of women showed normal levels of anxiety and depression, respectively, throughout treatment (resilient trajectories), 24 and 33% experienced anxiety and depression only during treatment (recovery trajectories), 4.6 and 4.9% experienced anxiety and depression only after treatment (delayed trajectories), and 4.3% showed chronic anxiety (chronic trajectory, not identified for depression). Non-resilient trajectories were associated with unsuccessful treatment, marital dissatisfaction, lack of social support and negative infertility cognitions. One in 10 women had a delayed or chronic trajectory and these trajectories predicted serious mental health impairment 11–17 years after treatment. LIMITATIONS, REASONS FOR CAUTION The study only focuses on women. In the OMEGA project adjustment was assessed using a mental health measure. Although we could investigate how trajectories predicted mental health, it would have been preferable to map anxiety and depression trajectories up to 11–17 years after treatment. Missing analysis showed selective dropout from the study but this was accounted for by using mixed models and imputation procedures. Finally, data on other life stressors were not collected; therefore any contribution from these events cannot be assessed. WIDER IMPLICATIONS OF THE FINDINGS Fertility health-care providers have been called upon considering their responsibility in supporting patients in the aftermath of treatment. Results show it is possible to profile different groups of at-risk women at the start of the treatment and tailor psychosocial support to risk profile to promote health adjustment during treatment and thereafter

Agricultural biomass as provisioning ecosystem service: quantification of energy flows

Agro-ecosystems supply provisioning, regulating and cultural services to human society. This study focuses on the agro-ecosystem provisioning services regarding the production of agricultural biomass. These services strongly respond to the socio-economic demands of human beings, and are characterised by an injection of energy in the ecosystems production cycle which is often exceeding the ecological capacity of the ecosystem, i.e. the overall ability of the ecosystem to produce goods and services linked to its bio-physical structure and processes that take place during the agricultural production. Agricultural production is identified as ecosystem service in widely recognised ecosystem service frameworks, but currently there is no clear agreement within the scientific and policy communities on how the ecological-socio-economic flow linked to this provisioning service should be assessed, beyond a mere accounting of yields. This study attempts to provide a new insight to this issue by proposing an approach based on the energy budget, which takes into consideration the energy needed by the ecosystem to supply the service. The approach is based on the concepts of Energy Return on Investment (EROI) and Net Energy Balance (NEB), and considers different bio-physical structures and processes of agroecosystems. The work is structured in three parts: the first aims at estimating inputs (machinery, seeds, fertilizers, irrigation, labour) in energy terms; the second at estimating biomass output in energy terms; the third to compare actual agricultural production with three reference scenarios encompassing a range of human input (no input – low input –high input scenarios). Results show that in general terms cereal and grassland systems have the largest energy gains (both in terms of EROI and NEB). Such systems are characterised by a lower economic value of their output compared to other producing systems such as fruits, which have lower energy gains but a higher embodied energy, which is recognized in the market as valuable. Comparison of actual production systems with the high input scenario confirms that current production in Europe is already highly intensive, and that increasing the energy input would not improve the efficiency of the conversion of such additional energy into biomass. Overall, the proposed approach seems a useful tool to identify which are the factors in the agricultural production process that could be modified to improve the energy efficiency in agricultural systems and the sustainability of their production. This study can be considered as a first step in the assessment of the total energy balance of the agro-ecosystem. In fact it deals with the quantification of energy regarding human inputs and the corresponding output and further analysis should address crucial issues such as the quality of the energy and the embodied energy in the plant production, which will help to better understand the complexity of the agro-ecosystems