Linkages Over Time Between Adolescents' Relationships with Parents and Friends

This 5-wave longitudinal study examines linkages over time between adolescents’ perceptions of relationships with parents and friends with respect to support, negative interaction, and power. A total of 575 early adolescents (54.1% boys) and 337 middle adolescents (43.3% boys) participated. Path analyses mainly showed bidirectional associations between adolescents’ perceptions of parent–adolescent relationships and friendships with a predominantly stronger influence from parent–adolescent relationships to friendships than vice versa in early to middle adolescence and an equal mutual influence in middle to late adolescence. The findings support the theoretical ideas that perceptions of relationships with parents generalize to perceptions of relationships with friends and that relationship skills and principles of adolescent friendships generalize to relationships with parents. Furthermore, the results indicate that the influence of parents decreases, whereas the influence of friends increases, and that both social worlds become equally important and overlapping towards late adolescence

Implementing a quality improvement programme in palliative care in care homes: a qualitative study

<p>Abstract</p> <p>Background</p> <p>An increasing number of older people reach the end of life in care homes. The aim of this study is to explore the perceived benefits of, and barriers to, implementation of the Gold Standards Framework for Care Homes (GSFCH), a quality improvement programme in palliative care.</p> <p>Methods</p> <p>Nine care homes involved in the GSFCH took part. We conducted semi-structured interviews with nine care home managers, eight nurses, nine care assistants, eleven residents and seven of their family members. We used the Framework approach to qualitative analysis. The analysis was deductive based on the key tasks of the GSFCH, the 7Cs: communication, coordination, control of symptoms, continuity, continued learning, carer support, and care of the dying. This enabled us to consider benefits of, and barriers to, individual components of the programme, as well as of the programme as a whole.</p> <p>Results</p> <p>Perceived benefits of the GSFCH included: improved symptom control and team communication; finding helpful external support and expertise; increasing staff confidence; fostering residents' choice; and boosting the reputation of the home. Perceived barriers included: increased paperwork; lack of knowledge and understanding of end of life care; costs; and gaining the cooperation of GPs. Many of the tools and tasks in the GSFCH focus on improving communication. Participants described effective communication within the homes, and with external providers such as general practitioners and specialists in palliative care. However, many had experienced problems with general practitioners. Although staff described the benefits of supportive care registers, coding predicted stage of illness and advance care planning, which included improved communication, some felt the need for more experience of using these, and there were concerns about discussing death.</p> <p>Conclusions</p> <p>Most of the barriers described by participants are relevant to other interventions to improve end of life care in care homes. There is a need to investigate the impact of quality improvement programmes in care homes, such as the GSFCH, on a wider range of outcomes for residents and their families, and to monitor the sustainability of any resulting improvements. It is also important to explore the impact of the different components of these complex interventions.</p

Quality of life of infertile couples in the public health sector in Chile Calidad de vida de parejas infértiles en el sector público de Chile

© 2018, Sociedad Medica de Santiago. All rights reserved. Background: It is widely known that infertility and its treatment have a negative impact on patients´ well-being, yet not much is known about patients´ satisfaction with the quality of reproductive care. Purpose: To assess the quality of life (QoL) of patients receiving medical care under the Chilean public health system. Materials and Methods: The FertiQoL international questionnaire was applied to 260 patients (both sexes) referred from rural and urban areas to undergo in vitro fertilization at a major university public hospital. FertiQol evaluates QoL as a product of psychosocial well-being and treatment experience. Demographic and reproductive data were collected. Results: QoL due to treatment factors was significantly lower than psychosocial well-being. Couples from lower-density areas showed markedly worse medical satisfaction than patients treated in Chile´s capital. No effects on QoL were observed as a function of age,

Quality of life of infertile couples in the public health sector in Chile

Background: It is widely known that infertility and its treatment have a negative impact on patients´ well-being, yet not much is known about patients´ satisfaction with the quality of reproductive care. Purpose: To assess the quality of life (QoL) of patients receiving medical care under the Chilean public health system. Materials and Methods: The FertiQoL international questionnaire was applied to 260 patients (both sexes) referred from rural and urban areas to undergo in vitro fertilization at a major university public hospital. FertiQol evaluates QoL as a product of psychosocial well-being and treatment experience. Demographic and reproductive data were collected. Results: QoL due to treatment factors was significantly lower than psychosocial well-being. Couples from lower-density areas showed markedly worse medical satisfaction than patients treated in Chile´s capital. No effects on QoL were observed as a function of age, education, or type of infertility. QoL was mostly affected by duration of infertility (inverse association) and geographical zone. Marital satisfaction was the component that most contributed to personal well-being. Conclusions: QoL decreased more due to extrinsic factors, particularly lack of access to reproductive care, poor organization of medical services, and deficient clinical interaction, than due to psychosocial distress. These findings call for a revision of the delivery of public fertility care to satisfy patients´ needs and improve their QoL

Attitudes and practice of couples regarding sexual relations during the menses and spotting

To determine attitudes and practices regarding sexual relations during menstruation and vaginal spotting, a crosssectional descriptive survey was performed at the Instituto de Investigaciones Materno Infantil, Universidad de Chile, Santiago, Chile. A total of 287 women and 206 men were randomly selected from an urban population. Attitudes, beliefs, and practices regarding sexual relations during vaginal bleeding were surveyed and stratified by educational level and other demographic characteristics. Overall, 70% of women and 72% of men were found to avoid sexual relations during menstruation. Fifty-four percent of women and 60% of men avoided sexual relations during vaginal spotting. Women with higher education (technical or university) were less likely to avoid sexual intercourse compared to those with a lower educational level (basic or secondary education) during menstruation (73% vs. 57%) and vaginal spotting (69% vs. 34%). Men with a higher educational level (university) avoided

Men's participation in psychologic counseling services offered during in vitro fertilization treatments

Objective: To assess frequency of male participation in psychologic support services during IVF treatments. Design: Retrospective descriptive study. Setting: University infertility clinic. Patient(s): A total of 284 low-income men receiving government-financed IVF. Intervention(s): Group counseling during treatment. Main Outcome Measure(s): Frequency of attendance to group counseling and perception of usefulness of the service. Result(s): One-half of the subjects enrolled in the counseling groups. There were no differences in clinical and demographic characteristics between attendants and nonattendants. Attendance was classified into three levels: occasional, intermediate, and consistent. Seventy-four percent of attendants fell into latter two categories. Significant differences were observed in frequency of attendance as a function of infertility etiology. Frequent attendants diagnosed with male-factor-only infertility were double the number of participants with female infertility. O

Perceptions and beliefs about embryo cryopreservation in women and men who carry out assisted reproduction technology in Santiago, Chile Percepciones y creencias sobre criopreservación embrionaria en mujeres y hombres que se realizan técnicas de reproducc

© 2018 Sociedad Chilena de Obstetricia y Ginecologia. All rights reserved. Background and objetive: Although embryo cryopreservation is frequently used as part of assisted reproductive technology, quantitave information addressing how infertile couples live the experience of having cryopreserved embryos is lacking in Chile. The aim of this study is to examine men and women's perception and beliefs regarding their cryopreserved embryos, as well as their perspective on embryo donation and disposition. Methods: 153 women and men with frozen embryos from a public hospital, Instituto de Investigactiones Materno Infantil, and a private clinic, Clínica Las Condes, in Santiago, Chile, responded between May 2015 and May 2016 to an anonymous online survey addressing their perceptions and beliefs concerning their cryopreserved embryos. Results: Respondents considered their frozen embryos to be equivalent to a child (53.2%) or a potential child (40.7%). Only 8% regard them as an organized group o

CRIOPRESERVACION DE PRONUCLEOS: ROL EN EL PROGRAMA DE FERTILIZACION ASISTIDA

Objetivo: Determinar el rol de la criopreservación (CP) de pronúcleos (PN), como una herramienta para disminuir la incidencia de embarazos múltiples y dar otra oportunidad de transferencia embrionaria, sin requerir estimulación ovárica nuevamente, en parejas con infertilidad que requieren como tratamiento algún tipo de procedimiento de Fertilización Asistida (FA). Material y Método: Se analizaron los resultados de 545 procedimientos de FA entre marzo del 2000 y junio del 2003. Resultados: La incorporación de la CP se logra en diciembre del 2001, criopreservando hasta la fecha el 51,3% de las parejas que tiene más de 6 folículos a aspirar. Se han criopreservado 623 PN dando un promedio 6,4 PN por pareja. Se han descongelado 166 PN, sobreviviendo 134 PN, lo que implica un 80,7%. Ciento catorce PN clivaron a embrión de 4 células, equivalente a un 85,1%. Se han transferido 114 PN en 39 ciclos con un promedio de 2,9 embriones por pareja, dando origen a 12 embarazos clínicos (30,7%) con una tasa implantacional del 11,4%. Se observa una reducción del número de embarazos múltiples en dobles del 23% al 15,5%, en triples del 7,6% al 2,2% y la no ocurrencia de cuádruples o más, al comparar el período 2000-diciembre 2001 (sin CP de PN), con diciembre de 2001-junio del 2003<br>Program at the San Borja Arriarán Clinical Hospital - University of Chile as a method of reducing the incidence of multiple pregnancies and providing an additional opportunity of embryo transfer, without requiring another hyperstimultaion ovarian cycle. Material and Methods: Five hundred and forty five Assisted Fertilization procedures have been performed between march 2000 and june 2003. Results: The PN cryopreservation program was approved by the Institutional Review Board in december 2001. Since then 51.3% of couples participating in our IVF program have asked for PN cryopreservation. The total number of PN (n= 623) that have been cryopreserved resulting in an average of 6.4 PN per couple. Presently, 166 PN have been unfrozen with a surviving rate of 80.7% (n= 134). Eighty five percent of the PN (n= 114) cleaved to four to six cells embryo. All of the have been transferred in 39 cycles with an average of 2.9 embryos per couple, originating 12 clinical pregnancies (30.7%) with 11.4% rate of implantation. The PN cryopreservation program has diminished in a significant manner the number of multiple pregnancies in twins (23% to 15.5%), as well as, triplets (7.6% o 2.2%). In addition we have not seen quadruples or more over the time agenda of the cryopreservation progra

CRIOPRESERVACION DE PRONUCLEOS: ROL EN EL PROGRAMA DE FERTILIZACION ASISTIDA

Objetivo: Determinar el rol de la criopreservación (CP) de pronúcleos (PN), como una herramienta para disminuir la incidencia de embarazos múltiples y dar otra oportunidad de transferencia embrionaria, sin requerir estimulación ovárica nuevamente, en parejas con infertilidad que requieren como tratamiento algún tipo de procedimiento de Fertilización Asistida (FA). Material y Método: Se analizaron los resultados de 545 procedimientos de FA entre marzo del 2000 y junio del 2003. Resultados: La incorporación de la CP se logra en diciembre del 2001, criopreservando hasta la fecha el 51,3% de las parejas que tiene más de 6 folículos a aspirar. Se han criopreservado 623 PN dando un promedio 6,4 PN por pareja. Se han descongelado 166 PN, sobreviviendo 134 PN, lo que implica un 80,7%. Ciento catorce PN clivaron a embrión de 4 células, equivalente a un 85,1%. Se han transferido 114 PN en 39 ciclos con un promedio de 2,9 embriones por pareja, dando origen a 12 embarazos clínicos (30,7%) con una tasa implantacional del 11,4%. Se observa una reducción del número de embarazos múltiples en dobles del 23% al 15,5%, en triples del 7,6% al 2,2% y la no ocurrencia de cuádruples o más, al comparar el período 2000-diciembre 2001 (sin CP de PN), con diciembre de 2001-junio del 200