Experiencing male infertility: A review of the qualitative research literature

This article examines the qualitative research literature that exists in relation to men’s experiences of male infertility. Since men have often been marginalized in the realm of reproduction, including academic research on infertility, it is important to focus on any qualitative research that gives voices to male perspectives and concerns. Given the distress documented by studies of infertile women, we focus in particular on the emotive responses and lived experiences of men in relation to infertility. In this article then, we present an analysis of the core themes across 19 qualitative articles, which include “infertility as crisis”; “emoting infertility- men as “being strong”’ “infertility as a source of stigma”; and the “desire for fatherhood.” In light of these insights, we identify key areas for future research and development including men’s emotional responses to infertility, how men seek support for infertility, the intersection between masculinity and infertility, the relationship between the desire to father and infertility, and the outcomes of infertility for men in terms of other aspects of their lives. We suggest that such research would facilitate making the experiences of men more central within our understandings of infertility within a field that has primarily been female focused

Design parameters for a siphon system

DHI are interested in understanding a rather unusual water extraction system that is operated by a water supply company. Typically when water is extracted from the ground a well is dug and a pump is installed in the well to push the water to the surface where it enters a distribution system of pipes. Such a system may consist of a dozen or so wells each connected to a single collection pipe. The system that DHI wish to more fully understand consists of a series of ten wells connected to a single collection pipe. The difference in the mode of operation is that the system contains no pumps in the wells. The force to collect the water comes from placing the end of the collection pipe in a tank that is continuously pumped to keep it at approximately 0.5 bar below atmospheric pressure. In this way the water is drawn out of the wells by a siphon mechanism. Such a system appears cheaper o install with fewer pumps and water supplied in this manner costs roughly half the price of water from a standard pump system. How this multiple siphon system works and how it might be controlled were the general problems of interest to the study group

How, when and where current mass flows in Martian gullies are driven by CO2 sublimation

Martian gullies resemble water-carved gullies on Earth, yet their present-day activity cannot be explained by water-driven processes. The sublimation of CO2 has been proposed as an alternative driver for sediment transport, but how this mechanism works remains unknown. Here we combine laboratory experiments of CO2-driven granular flows under Martian atmospheric pressure with 1D climate simulation modelling to unravel how, where, and when CO2 can drive present-day gully activity. Our work shows that sublimation of CO2 ice, under Martian atmospheric conditions can fluidize sediment and creates morphologies similar to those observed on Mars. Furthermore, the modelled climatic and topographic boundary conditions for this process, align with present-day gully activity. These results have implications for the influence of water versus CO2-driven processes in gully formation and for the interpretation of gully landforms on other planets, as their existence is no longer definitive proof for flowing liquids

Women's perceptions of fertility assessment and counselling six years after attending a Fertility Assessment and Counselling clinic in Denmark

STUDY QUESTION What are women’s perceptions and experience of fertility assessment and counselling 6 years after attending a Fertility Assessment and Counselling (FAC) clinic in Denmark? SUMMARY ANSWER Women viewed the personalized fertility knowledge and advice they received as important aids to decision-making and they felt the benefits outweighed the risks of receiving personalized fertility information. WHAT IS KNOWN ALREADY Many young people wish to become parents in the future. However, research demonstrates there is a gap in women’s and men’s knowledge of fertility and suggests they may be making fertility decisions based on inaccurate information. Experts have called for the development of interventions to increase fertility awareness so that men and women can make informed fertility decisions and achieve their family-building goals. Since 2011, the FAC clinic in Copenhagen, Denmark has provided personalized fertility assessment and guidance based on clinical examination and evaluation of individual risk factors. Available qualitative research showed that attending the FAC clinic increased fertility awareness and knowledge and was experienced as a catalyst for change (e.g. starting to conceive, pursuing fertility treatment, ending a relationship) in women 1-year post-consultation. STUDY DESIGN, SIZE, DURATION The study was a 6-year follow-up qualitative study of 24 women who attended the FAC clinic between January and June 2012. All women were interviewed during a 2-month period from February to March 2018 at Rigshospitalet, their home or office, in Copenhagen, Denmark. Interviews were held in English and ranged between 60 and 94 min (mean 73 min). PARTICIPANTS/MATERIALS, SETTING, METHODS Invitations to participate in an interview-based follow-up study were sent to 141 women who attended the FAC clinic in 2012. In total, 95 women read the invitation, 35 confirmed interest in participating and 16 declined to participate. Twenty-five interviews were booked and 24 interviews held. Interviews followed a semi-structured format regarding reasons for attending the FAC clinic, if/how their needs were met, and perceptions of fertility assessment and counselling. Data were analysed using thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE At the follow-up interview, women were on average 39.5 years old. Ten were currently single or dating and 14 were married/cohabiting. All were childless when they attended the FAC clinic. At the follow-up interview, 21 women were parents (14 women with one child; 6 with two children; 1 with three children) and the remaining three women intended to have children in the future. The most common reason for originally attending the FAC clinic was to determine how long they could delay childbearing. Most of the women now believed their needs for attending had been met. Those who were dissatisfied cited a desire for more exact (‘concrete’) information as to their remaining years of fertility, although acknowledged that this was likely not realistic. Women stated that they had felt reassured as to their fertility status after attending the FAC clinic whilst receiving the message that they could not delay childbearing ‘too long’. Women viewed personalized fertility knowledge as an important aid to decision-making but cautioned about developing a false sense of security about their fertility and chance of conceiving in the future based on the results. Although women were generally satisfied with their experience, they wished for more time to discuss options and to receive additional guidance after their initial meeting at the FAC clinic. LIMITATIONS, REASONS FOR CAUTION Participants were from a group of Danish women attending the FAC clinic and interviews were conducted in English, which means they are not representative of all reproductive-aged women. Nevertheless, the study group included a broad spectrum of women who achieved parenthood through different means (heterosexual/lesbian relationship, single parent with donor, co-parent) with various family sizes, and women who were currently childless. WIDER IMPLICATIONS OF THE FINDINGS Our study provides support for an individualized approach to fertility education, assessment and counselling provided at a time when the information is relevant to the individual and their current fertility decision-making. The findings suggest that although satisfied with their visit to the FAC clinic, the women wished for more information and guidance after this visit, suggesting that the current intervention may need to be expanded or new interventions developed to meet these additional needs

Influenza and associated co-infections in critically ill immunosuppressed patients

Abstract Background It is unclear whether influenza infection and associated co-infection are associated with patient-important outcomes in critically ill immunocompromised patients with acute respiratory failure. Methods Preplanned secondary analysis of EFRAIM, a prospective cohort study of 68 hospitals in 16 countries. We included 1611 patients aged 18 years or older with non-AIDS-related immunocompromise, who were admitted to the ICU with acute hypoxemic respiratory failure. The main exposure of interest was influenza infection status. The primary outcome of interest was all-cause hospital mortality, and secondary outcomes ICU length of stay (LOS) and 90-day mortality. Results Influenza infection status was categorized into four groups: patients with influenza alone (n = 95, 5.8%), patients with influenza plus pulmonary co-infection (n = 58, 3.6%), patients with non-influenza pulmonary infection (n = 820, 50.9%), and patients without pulmonary infection (n = 638, 39.6%). Influenza infection status was associated with a requirement for intubation and with LOS in ICU (P < 0.001). Patients with influenza plus co-infection had the highest rates of intubation and longest ICU LOS. On crude analysis, influenza infection status was associated with ICU mortality (P < 0.001) but not hospital mortality (P = 0.09). Patients with influenza plus co-infection and patients with non-influenza infection alone had similar ICU mortality (41% and 37% respectively) that was higher than patients with influenza alone or those without infection (33% and 26% respectively). A propensity score-matched analysis did not show a difference in hospital mortality attributable to influenza infection (OR = 1.01, 95%CI 0.90–1.13, P = 0.85). Age, severity scores, ARDS, and performance status were all associated with ICU, hospital, and 90-day mortality. Conclusions Category of infectious etiology of respiratory failure (influenza, non-influenza, influenza plus co-infection, and non-infectious) was associated with ICU but not hospital mortality. In a propensity score-matched analysis, influenza infection was not associated with the primary outcome of hospital mortality. Overall, influenza infection alone may not be an independent risk factor for hospital mortality in immunosuppressed patients