The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate

BACKGROUND: Psychological interventions for infertile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analysis was to examine if psychological interventions improve mental health and pregnancy rate among infertile patients. Thus, controlled studies were pooled investigating psychological interventions following the introduction of assisted reproductive treatments (ART). METHODS: The databases of Medline, PsycINFO, PSYNDEX, Web of Science and the Cochrane Library were searched to identify relevant articles published between 1978 and 2007 (384 articles). Included were prospective intervention studies on infertile patients (women and men) receiving psychological interventions independent of actual medical treatment. The outcome measures were mental health and pregnancy rate. A total of 21 controlled studies were ultimately included in a meta-analysis comparing the efficacy of psychological interventions. Effect sizes (ES) were calculated for psychological measures and risk ratios (RR) for pregnancy rate. RESULTS: The findings from controlled studies indicated no significant effect for psychological interventions regarding mental health (depression: ES 0.02, 99% CI: -0.19, 0.24; anxiety: ES 0.16, 99% CI: -0.10, 0.42; mental distress: ES 0.08, 99% CI: -0.10, 0.51). Nevertheless, there was evidence for the positive impact of psychological interventions on pregnancy rates (RR 1.42, 99% CI: 1.02, 1.96). Concerning pregnancy rates, significant effects for psychological interventions were only found for couples not receiving ART. CONCLUSIONS: Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment.

Frequency of PRRS live vaccine virus (European and North American genotype) in vaccinated and non-vaccinated pigs submitted for respiratory tract diagnostics in North-Western Germany

The frequency of PRRSV corresponding to live vaccines and wild-type was determined in 902 pigs from North-Western Germany submitted for post-mortem examination. Overall, 18.5% of the samples were positive for the EU wild-type virus. EU genotype vaccine virus was detected in 1.3% and the NA genotype vaccine virus in 8.9% of all samples. The detection of the EU vaccine was significantly higher in pigs vaccinated with the corresponding vaccine (OR=9.4). Pigs vaccinated with NA genotype had significantly higher detection chances for the corresponding vaccine virus when compared to non-vaccinated animals (OR=3.34) animals, however, NA vaccine was also frequently detected in non-vaccinated pigs. Concluding, the dynamics of NA genotype vaccine and EU wild-type virus corresponds with studies on PRRSV spread in endemically infected herds. The potential of spontaneous spread of the NA genotype vaccine should be considered in the planning of eradication programs.

Genetic and phenotypic diversity in selected genotypes of tef [Eragrostis tef (Zucc.)] Trotter

Tef [Eragrostis tef (Zucc.) Trotter] is an important staple food crop, especially in Ethiopia where it is annually grown on 2.8 million hectares of land. It is important for food security in the region, in spite of having a low yield, mainly due to lodging. In this study, 15 representative landraces as well as three improved varieties have been selected for in-depth characterization of many parameters, especially those implicated in yield. The genotypes were clustered into six groups, mainly based on agronomic traits and about 80% of the diversity in the genotypes could be explained on the basis of four principal components. In general, all traits investigated showed substantial diversity among genotypes, offering high chances for improving tef through direct selection or intra-specific hybridization. Moreover, in view of climatic changes, breeding with early maturing landraces such as Red dabi or Karadebi would be advantageous to cope with moisture scarcity during the later stage of crop maturity.

Environmental justice and health practices: understanding how health inequities arise at the local level

While empirical evidence continues to show that people living in low socio-economic status neighbourhoods are less likely to engage in health-enhancing behaviour, our understanding of why this is so remains less than clear. We suggest that two changes could take place to move from description to understanding in this field; (i) a move away from the established concept of individual health behaviour to a contextualised understanding of health practices; and (ii) a switch from focusing on health inequalities in outcomes to health inequities in conditions. We apply Pierre Bourdieu's theory on capital interaction but find it insufficient with regard to the role of agency for structural change. We therefore introduce Amartya Sen's capability approach as a useful link between capital interaction theory and action to reduce social inequities in health-related practices. Sen's capability theory also elucidates the importance of discussing unequal chances in terms of inequity, rather than inequality, in order to underscore the moral nature of inequalities. We draw on the discussion in social geography on environmental injustice, which also underscores the moral nature of the spatial distribution of opportunities. The article ends by applying this approach to the 'Interdisciplinary study of inequalities in smoking' framework.

Annexations in Europe and the Persecution of Jews, 1939-1944

This contribution tries to explain why Jews were persecuted earlier or more fiercely in territories annexed by a state during World War II than in the mainland of that state. The case-studies covered are Nazi Germany, Romania, Hungary, Bulgaria, and the USSR. It is argued that internationally, similar policies of incorporation, especially the replacement of existing elites and the process of bringing in new settlers, worked against the Jews. Aside from focusing on governmental policies, the contribution also sketches the manner in which individual actions by state functionaries (who did not merely implement state policies) and by non-state actors had adverse effects on the Jewish population, impacting their survival chances. Finally, the article places the persecution of Jews in annexed areas in the context of the concerted violence conducted, at the same time, against other ethnically defined, religious, and social groups.

Sugar concentration influences decision making in <i>Apis mellifera</i> L. workers during early-stage honey storage behaviour

Decision making in honeybees is based on in- formation which is acquired and processed in order to make choices between two or more al- ternatives. These choices lead to the expression of optimal behaviour strategies such as floral constancy. Optimal foraging strategies such as floral constancy improve a colony’s chances of survival, however to our knowledge, there has been no research on decision making based on optimal storage strategies. Here we show, using diagnostic radioentomology, that decision mak- ing in storer bees is influenced by nectar sugar concentrations and that, within 48 hours of col- lection, honeybees workers store carbohydrates in groups of cells with similar sugar concentra- tions in a nonrandom way. This behaviour, as evidenced by patchy spatial cell distributions, would help to hasten the ripening process by reducing the distance between cells of similar sugar concentrations. Thus, colonies which ex- hibit optimal storage strategies such as these would have an evolutionary advantage and im- prove colony survival expectations over less efficient colonies and it should be plausible to select colonies that exhibit these preferred traits.

Intergenerationale Mobilität im Lebensverlauf oder: Ist der öffentliche Dienst ein Mobilitätskanal zwischen Generationen?

Aus der Lebensverlaufsperspektive wird die intergenerationale Mobilität von Männern und Frauen in den Kohorten 1929-31, 1939-41 und 1949-51 untersucht. In welchem Umfang hat die Expansion des öffentlichen Dienstes Mobilitätschancen eröffnet? Inwieweit hat der öffentliche Dienst als Sonderstruktur im Gegensatz zur Privatwirtschaft seine Funktion als "Mobilitätskanal" ausgeweitet? Modifizieren für den öffentlichen Dienst charakteristische institutionelle Regelungen der Rekrutierung und Allokation von Arbeitskräften diese Funktion? Für empirische Analysen wurden Längsschnittdaten des Lebensverlaufsprojekts am Berliner Max-Planck-Institut für Bildungsforschung herangezogen. Zunehmende herkunftsbedingte und bildungsmäßige Ungleichheit bestimmen einen Großteil der Chancen intergenerationaler Mobilität. Die Ausdehnung der Staatsbeschäftigung hat dazu geführt, daß in der Kohortenabfolge vor allem die Berufsanfänger aufstiegen, die in der Lage waren, in den öffentlichen Dienst einzutreten. Das Nachholen beim Berufseinstieg verpaßter Aufstiege ist kaum möglich, und dies gelingt auch nicht durch die Beschäftigung im öffentlichen Dienst. Für die Wahrscheinlichkeit intergenerationaler Aufstiege im Berufsverlauf gibt es keine sektorspezifischen Unterschiede. Staatsbeschäftigte unterliegen aufgrund der Besitzstandswahrung einem deutlich geringeren Abstiegsrisiko als privatwirtschaftlich Beschäftigte. Der Staatssektor hat seine Funktion als Aufstiegskanal für Berufsanfänger ausgeweitet und garantiert seinen langfristig Beschäftigten die erreichte Statuslage. Damit ist der öffentliche Dienst ein weiteres Strukturprinzip sozialer Ungleichheit.

Assessment of detectability of neutral interstellar deuterium by IBEX observations

Context. The abundance of deuterium in the interstellar gas in front of the Sun gives insight into the processes of filtration of neutral interstellar species through the heliospheric interface and potentially into the chemical evolution of the Galactic gas. Aims: We investigate the possibility of detection of neutral interstellar deuterium at 1 AU from the Sun by direct sampling by the Interstellar Boundary Explorer (IBEX). Methods: Using both previous and the most recent determinations of the flow parameters of neutral gas in the local interstellar cloud (LIC) and an observation-based model of solar radiation pressure and ionization in the heliosphere, we simulated the flux of neutral interstellar D at IBEX for the actual measurement conditions. We assessed the number of interstellar D atom counts expected during the first three years of IBEX operation. We also simulated the observations expected during an epoch of high solar activity. In addition, we calculated the expected counts of D atoms from the thin terrestrial water layer covering the IBEX-Lo conversion surface, sputtered by neutral interstellar He atoms. Results: Most D counts registered by IBEX-Lo are expected to come from the water layer, exceeding the interstellar signal by 2 orders of magnitude. However, the sputtering should stop once the Earth leaves the portion of orbit traversed by interstellar He atoms. We identify seasons during the year when mostly the genuine interstellar D atoms are expected in the signal. During the first 3 years of IBEX operations about 2 detectable interstellar D atoms are expected. This number is comparable to the expected number of sputtered D atoms registered during the same time intervals. Conclusions: The most favorable conditions for the detection occur during low solar activity, in an interval including March and April each year. The detection chances could be improved by extending the instrument duty cycle, say, by making observations in the special deuterium mode of IBEX-Lo.

Aggression und soziale Interaktion im Erziehungsheim

In einer Kamerabrillenstudie werden die sozialen und materiellen Umwelten von Jugendlichen, die in Erziehungsheimen für verhaltensauffällige und sozial beeinträchtigte Kinder und Jugendliche leben, untersucht und mit einer Kontrastgruppe nicht verhaltensauffälliger, zuhause lebender Jugendlichen verglichen. Die Ergebnisse deuten darauf hin, dass Heimjugendliche über einen eingeschränkten Streifraum verfügen, weniger mit Peers interagieren und mehr Aggression ausgesetzt sind. Für den Erfolg der Heimerziehung ist es zentral, Peers nicht unbeaufsichtigt zu lassen, weil durch eine negative Peerbeeinflussung der Erfolg der Intervention geschwächt wird.

Salvage Radiotherapy After Radical Prostatectomy

Salvage radiation therapy is the sole curative treatment for patients experiencing biochemical relapse after radical surgical treatment of prostate cancer. The main dilemma in salvage radiation therapy is, whether or not biochemical relapse represents purely localized recurrent disease in the prostatic fossa or systemic micrometastasis. Initiating salvage radiation therapy at an early time point raises its chances of success, but may lead to overtreatment of patients. Target volume definition and treatment techniques are a matter of current research, with still many questions unanswered. Strategies of treatment escalation either by increasing the treatment dose or combining radiation therapy with androgen deprivation therapy are being addressed in clinical trials.

Factors affecting screening for hepatocellular carcinoma

Background and aim. Hepatocellular carcinoma (HCC) is a frequent cancer. Its prognosis is highly dependent on early diagnosis. Patients at risk for developing HCC should be enrolled in a surveillance programme. Nevertheless, many patients at risk are not regularly screened. We aimed at exploring the characteristics that affect enrolment in a surveillance programme. Material and methods. The characteristics of the patients included in the prospective Bern HCC cohort between August 2010 and August 2011 were analysed according to their participation in a surveillance programme. Results. Among the 82 patients included in the cohort during this period of time, 48 were in a surveillance program before the diagnosis of HCC. Thirty five percent of cirrhotic patients were not screened. Age, sex, level of education, Child-Pugh status and MELD score were similar between the patients who were screened and those who were not screened. Patients with a private insurance and patients treated by a liver specialist were more frequently enrolled in a surveillance program. Sixty seven percent of the screened patients were eligible for curative treatment whereas only 15% of the non-screened patients were. Conclusions. In conclusion the surveillance of patients at risk for developing HCC increases their chances to be diagnosed at an early stage to allow curative treatment. More than one third of cirrhotic patients were not regularly screened. Patients with chronic liver disease should be referred to identify those at risk and enrol them in a surveillance program.

Good just isn't Good enough. Best System Probabilities and the Foundations of Statistical Mechanics

Statistical physicists assume a probability distribution over micro-states to explain thermodynamic behavior. The question of this paper is whether these probabilities are part of a best system and can thus be interpreted as Humean chances. I consider two strategies, viz. a globalist as suggested by Loewer, and a localist as advocated by Frigg and Hoefer. Both strategies fail because the system they are part of have rivals that are roughly equally good, while ontic probabilities should be part of a clearly winning system. I conclude with the diagnosis that well-defined micro-probabilities under-estimate the robust character of explanations in statistical physics.

Migrant Background and Higher Education Participation in Europe. The Effect of the Educational Systems

The main aim of this article is to shed light on the extent to which differences in higher education participation between people with and without a migrant background of low/higher social origin can be explained by two macro-level characteristics of national educational institutions: stratification of the secondary school system and provision of alternative access to higher education. General assumptions are that people with a migrant background of low social origin benefit in low-stratified secondary school systems and in systems that provide alternative access to institutions of higher education more than their native peers in the same social stratum, owing to primary and secondary effects of migrant background. Database is a pooled dataset of the five waves of the European Social Survey. Results of logistic multi-level analyses indicate that a low-stratified secondary school system improves the probability of people with a migrant background/low social origin attaining a higher education degree. On the other hand, a stratified secondary school system reduces their chances regarding this educational stage. The provision of alternative access to an institution of higher education improves their likelihood of becoming higher education graduates.

Understanding the underlying mechanisms of recent Jatropha curcas L. adoption by smallholders in Kenya: A rural livelihood assessment in Bondo, Kibwezi, and Kwale districts

Between 2004 and 2007, NGOs, community based organisations and private investors promoted jatropha in Kenya with the aim of generating additional income and producing biofuel for rural development. By 2008 it became gradually evident that jatropha plantations (both mono- and intercropping) are uneconomical and risky due to competition for land and labour with food crops. Cultivation of jatropha hedges was found to have better chances of economic success and to present only little risks for the adopting farmers. Still, after 2008 a number of farmers went on adopting jatropha in plots rather than as hedges. It is hypothesised that lack of awareness about the low economic prospects of jatropha plantations was the main reason for continued adoption, and that smallholder farmers with higher resource endowments mainly ventured into its cultivation. In this study we provide an empirical basis for understanding the role of households' capital assets in taking up new livelihood strategies by smallholder farmers in three rural districts in Kenya. For that purpose, we assess the motivation and enabling factors that led to the adoption of jatropha as a new livelihood strategy, as well as the context in which promotion and adoption took place. A household survey was conducted in 2010, using a structured questionnaire, to collect information on household characteristics and capital asset endowment. Data were analysed using descriptive statistics and non-parametric statistical tests. We established that access to additional income and own energy supply were the main motivation for adoption of jatropha, and that financial capital assets do not necessarily have a positive influence on adoption as hypothesised. Further, we found that the main challenges that adopting farmers faced were lack of access to information on good management practices and lack of a reliable market. We conclude that continued adoption of on-farm jatropha after 2008 is a result of lacking awareness about the low economic value of this production type. We recommend abandoning on-farm production of jatropha until improved seed material and locally adapted agronomic knowledge about jatropha cultivation becomes available and its production becomes economically competitive.