Factors associated with the donation and non-donation of embryos for research: a systematic review

Background: Systematic knowledge on the factors that influence the decisions of IVF users regarding embryo donation for research is a core need for patient-centred policies and ethics in clinical practice. However, no systematic review has been provided on the motivations of patients who must decide embryo disposition. This paper fills this gap, presenting a systematic review of quantitative and qualitative studies, which synthesizes the current body of knowledge on the factors and reasons associated with IVF patients’ decisions to donate or not to donate embryos for research. Methods: A systematic search of studies indexed in PubMed, ISIWoK and PsycINFO, published before November 2013, was conducted. Only empirical, peer-reviewed, full-length, original studies reporting data on factors and reasons associated with the decision concerning donation or non-donation of embryos for research were included. Eligibility and data extraction were performed by two independent researchers and disagreements were resolved by discussion or a third reviewer, if required. The main quantitative findings were extracted and synthesized and qualitative data were assessed by thematic content analysis. Results: A total of 39 studies met the inclusion criteria and were included in the review. More than half of the studies (n ¼ 21) used a quantitative methodology, and the remaining were qualitative (n ¼ 15) or mixed-methods (n ¼ 3) studies. The studies were derived mainly from European countries (n ¼ 18) and the USA(n ¼ 11). The proportion of IVF users who donated embryos for research varied from 7% in a study in France to 73% in a Swiss study. Those who donate embryos for research reported feelings of reciprocity towards science and medicine, positive views of research and high levels of trust in the medical system. They described their decision as better than the destruction of embryos and as an opportunity to help others or to improve health and IVF treatments. The perception of risks, the lack of information concerning research projects and the medical system and the conceptualization of embryos in terms of personhood were the most relevant motives for not donating embryos for research. Results relating to the influence of sociodemographic characteristics and reproductive and gynaecological history were mostly inconclusive. Conclusions: Three iterative and dynamic dimensions of the IVF patients’ decision to donate or not to donate embryos for research emerged from this review: the hierarquization of the possible options regarding embryo disposition, according to the moral, social and instrumental status attributed to embryos; patients’ understanding of expectations and risks of the research on human embryos; and patients’ experiences of information exchange and levels of trust in the medical-scientific institutions.

Conceções éticas de estudantes universitários portugueses sobre as sentenças penais: reabilitar ou retribuir?

A presente investigação tem como objetivo analisar as perceções dos estudantes universitários portugueses sobre as finalidades das sentenças penais tendo subjacentes as Teorias Absolutas e das Teorias Relativas. Pretendeu-se avaliar que objetivos de sentença são mais apoiados entre os estudantes e perceber se existem outras variáveis como preditores significativos, tais como, género, orientação politica, religião, curso e experiência prévia de vitimação. Uma amostra de 344 estudantes universitários, a frequentar os cursos de Ciências Sociais (40,8%), Engenharia (34,9%) e Direito (24,3%), com idades compreendidas entre os 17 e os 48 anos, selecionada por conveniência, preencheu o instrumento de 20 itens adaptado de Cullen, Cullen, e Wozniak. Os resultados apontam para a estabilidade da estrutura dimensional do instrumento adaptado, definido por 2 fatores e 16 itens: o fator punição e o fator reabilitação. O fator mais apoiado entre os participantes foi o de reabilitação o que contraria que a opinião pública a respeito da sentença é mais influenciada pelo retribucionismo. Os participantes apoiam várias finalidades da sentença. Não foram encontradas diferenças estatisticamente significativas em função da orientação política, da religião e da experiência de vitimização. Contudo, diferenças estatisticamente significativas foram encontradas para o sexo dos participantes e para o curso.

Quality of life in women with urinary incontinence

The aim of this study is to examine the relationship among psychological, clinical and sociodemographic variables, and quality of life in women with urinary incontinence. The sample consisted of 80 women diagnosed with urinary incontinence (UI) followed in a Northern Central Hospital in Portugal. Participants answered the Incontinence Quality of Life (I-QOL); Satisfaction with Sexual Relationship Questionnaire (SSRQ); Hospital Anxiety and Depression Scales (HADS) and the Brief Cope. The results revealed that women with higher quality of life considered their symptoms of urine loss as mild or moderated compared to those with severe urine loss. The less severe urine loss was associated with greater sexual satisfaction and less use of religion and self-blame as coping strategies. In terms of coping, women who considered the loss of urine as severe expressed more feelings regarding UI. Stress urinary incontinence, high sexual satisfaction, and less use of denial, distraction, and religion as coping strategies, predicted higher quality of life. According to the results, UI has an impact on women’s sexual satisfaction and quality of life. Therefore, intervention programs should target these women, including their partners, helping them to adjust to their condition and teaching effective coping strategies in order to improve their sexual satisfaction and quality of life.

As fontes jornalísticas na era digital: relações e encenação

Dissertação de mestrado em Ciências da Comunicação (área de especialização em Informação e Jornalismo)