Mental health and coping with fertility treatment cessation during the COVID-19 pandemic in the UK

Purpose This study examined experiences during the cessation of fertility treatment due to the COVID-19 pandemic, including levels of mental health, coping strategies used to manage uncertainty about treatment due to the pandemic, sources of support, and predictors of mental health. Methods One hundred and seventy-five participants in the UK completed an online survey. Results Half of the participants experienced clinical levels of anxiety and/or depression, and 20% reported suicidal feelings as a result of the uncertainty about treatment due to the pandemic. Support from friends, family and online forums were reported by more than half of participants, but support from fertility clinics or counsellors were reported by less than one quarter. The strategy used most frequently to cope with the uncertainty about treatment due to the pandemic was self-distraction, and this predicted reduced depression. However, self-blame, behavioral disengagement and venting predicted increased depression and self-blame, behavioral disengagement, and denial predicted increased anxiety. Conclusions Fertility clinic communication and psychological support, such as counselling, which had substantially reduced during treatment cessation, could include some focus on personal coping, including what to avoid. Psychological support is likely to be more important now than ever. Despite resumption of treatment, the impacts of the period of cessation and of COVID-19 are likely to continue to reverberate

Catch 22? Disclosing assisted conception treatment at work

Purpose: The purpose of this study was to explore factors influencing decision-making about disclosure of Assisted Reproductive Technology (ART) use in the workplace. Design: A qualitative study design was used. Thirty-one women and six men who were using or had recently used ART were recruited from British fertility networks and interviewed. Data were transcribed verbatim and thematically analysed. Findings: Two main strands were identified each encompassing two themes: i) ‘Concerns about disclosure’ covered the very personal nature of disclosing ART treatment and also career concerns and ii) ‘Motives for disclosure’ covered feeling it was necessary to disclose and also the influence of workplace relationships. Research limitations: The relatively small, self-selected sample of participants was recruited from fertility support networks, and lacked some diversity. Practical implications: Clarity about entitlements to workplace support and formal protection against discrimination, along with management training and awareness raising about ART treatment is needed to help normalise requests for support and to make decisions about disclosure within the workplace easier. Originality/ value: The study has highlighted an understudied area of research in ART populations. The data provide insight into the challenging experiences of individuals combining ART with employment and, in particular, the complexity of decisions about whether or not to disclose

Experiences and psychological distress of fertility treatment and employment

Purpose: This study examined experiences and psychological distress about fertility treatment in people combining work and treatment. Methods: 563 participants in the UK completed an online survey asking about difficulties in combining work and treatment; workplace disclosure, support, absence and policy; and psychological distress about treatment. Results: Absence from work and perceptions that treatment has an impact on work and career prospects were reported by the majority of participants and this was related to the psychological distress of treatment. Around three quarters of participants disclosed to their employer and colleagues. The key reason for disclosure was needing to ask for absence from work and the main reason for non-disclosure was privacy. Workplace policy relating to managing fertility treatment and support from colleagues and their employer was related to reduced psychological distress but workplace policy was reported by less than one quarter of participants. Conclusions: Difficulties experienced in combining work and treatment suggest that support is needed. Specific workplace policy, guidance for supervisors and flexibility in fertility clinic times should help support employees during treatment and reduce psychological distress, thereby potentially influencing physical health and treatment outcomes

Experiences of involuntary childlessness and treatment in the UK: what has changed in 20 years?

This study examined the financial, emotional and relationship impacts of involuntary childlessness and treatment, and satisfaction with support from professionals. 796 participants in the UK completed an online survey based on a survey conducted in 1997. 55% of participants had to pay for at least part of their treatment. High levels of distress were experienced and 42% experienced suicidal feelings at least occasionally. Those most at risk of suffering distress and suicidal feelings at some point had only experienced unsuccessful treatment outcomes, spent longer trying to conceive and experienced some relationship strains. 75% would like to have counselling if it were free but 45% received counselling and 54% of these had to fund some of it themselves. Thus although advances have been made in the availability of funded treatment and psychological support, involuntary childlessness and treatment continue to have financial, emotional and relationship consequences for many people. While counselling was generally reported to be useful, a whole clinic approach involving all fertility clinic staff in the psychosocial care of clients is advisable

A qualitative exploration of health-related quality of life and health behaviours in children with sickle cell disease and healthy siblings

Objectives This study explored the health-related quality of life (HRQL) and health behaviours of children with sickle cell disease (SCD) and healthy siblings, drawing on Gap theory, which suggests HRQL is the discrepancy between current and ideal selves. Design Thirty-two interviews, facilitated by children’s drawings of their current and ideal selves were thematically analysed. Results Two themes were identified. First, limitations of SCD and adjusted expectations. Children with SCD report some discrepancy in HRQL as they would like to participate in more physical activity, but overall, they appear to have normalised their condition and adjusted their expectations in the context of the limits of their condition. Healthy siblings worry about their sibling and have greater expectations about engaging in adventurous activities and for their future. Second, coping with SCD. Children have limited social support, although children with SCD seek support from their mothers. They also modify health behaviours, like reducing exercise to help prevent and cope with sickle-related pain. Conclusion Children have some discrepancies in their HRQL but adjusted expectations among children with SCD may reduce discrepancy. Adapting health behaviours may help to cope with SCD but it is important that reductions in physical activity do not impair HRQL

Introducing a variable speed of sound in single-component lattice Boltzmann simulations of isothermal fluid flows

To simulate the hydrodynamics and mixing characteristics of chemical reactors by means of a lattice Boltzmann method (LBM), it is essential to consider components with varying molecular weights (and therefore speeds of sound). This option requires modification of the standard equilibrium distribution function and the use of an extended velocity set. In this paper, we show that, for isothermal incompressible single-component non-reactive flows, tuning the speed of sound with a modified equilibrium distribution and an extended velocity set allows for reproducing the proper flow characteristics with strongly reduced errors (compared to LBM simulations on standard lattices). This is done for two isothermal benchmarks, viz. a damped standing pressure wave and a decaying viscous Taylor–Green Vortex. The convergence as a function of the number of lattice nodes used improves substantially for varying values of the speed of sound

A decision analysis approach for optimal groundwater monitoring system design under uncertainty

International audienceGroundwater contamination is the degradation of the natural quality of groundwater as a result of human activity. Landfills are one of the most common human activities threatening the groundwater quality. The objective of the monitoring systems is to detect the contaminant plumes before reaching the regulatory compliance boundary in order to prevent the severe risk to both society and groundwater quality, and also to enable cost-effective counter measures in case of a failure. The detection monitoring problem typically has a multi-objective nature. A multi-objective decision model (called MONIDAM) which links a classic decision analysis approach with a stochastic simulation model is applied to determine the optimal groundwater monitoring system given uncertainties due to the hydrogeological conditions and contaminant source characteristics. A Monte Carlo approach is used to incorporate uncertainties. Hydraulic conductivity and the leak location are the random inputs of the simulation model. The design objectives considered in the model are: (1) maximizing the detection probability, (2) minimizing the contaminated area and, (3) minimize the total cost of the monitoring system. The results show that the monitoring systems located close to the source are optimal except for the cases with very high unit installation and sampling cost and/or very cheap unit remediation cost

Прибыльность предприятия и стратегия ее обеспечения

Целью статьи является системное развитие теоретических, научно-методических и практических положений обеспечения прибыльности предприятия с помощью специально разработанных стратегий, которые направлены на повышение конкурентоспособности и эффективности развития предприятия, обоснование путей улучшения управления прибыльностью предприятий на основе различных исследований