Exploring the Family Context Among Children Adopted From China: Perceptions of Pre-Adoption Factors, Post-Adoption Experiences, and the Quality of Parent-Child Relationships

Within the context of international adoption, previous research has focused on parentchild attachment relationships and various aspects of the adoption process. However, less is known about other aspects of parent-child relationships (e.g., cohesion, conflict) within internationally adoptive families. Additionally, there is a need for research that explores both parent and child perceptions of the process of adoption - including pre- and post-adoptive factors - and its connection to the quality of parent-child relationships. This research utilized a qualitatively-oriented methodology to conduct separate, in-depth interviews with 10 adoptive Canadian mothers and their adopted Chinese children (aged 9 to 11 years). Results highlight parent and child reports of mainly strong, positive relationships. Several pre-adoption experiences are examined, including institutionalization, age at the time of adoption, and parental stress/expectations. A key finding concerns the link that adoptive parents perceive between the quality of their child's pre-adoptive care (i.e., mainly early institutionalized care) and the quality of their relationship. Interestingly, this link is perceived in two different ways - either as a challenge for the parent-child relationship or as a means to strengthen it. Post-adoption experiences are also explored, including cultural socialization, creating a transracial family, discussing adoption, parental stress, and sibling involvement. A key finding involves parent and child reports that cultural socialization efforts (i.e., familiarizing children with Chinese culture) are linked to more positive parent-child relationships. The implications of these findings are discussed in relation to theory and practice within the context of international adoption.

Optimization Studies to Improve MSC-based Cardiac Cell Therapy : Cytokine Preconditioning and Nanoparticle Coupling

Contexte: La cardiopathie ischémique (IHD) reste une cause majeure de mortalité en Amérique du Nord. La thérapie cellulaire cardiaque (CCT) a émergé comme une thérapie prometteuse pour aider à guérir certaines malades cardiaques. Parmi les cellulaires avec propriétés pluripotentes, les cellules stromales mésenchymateuses (MSC) sont prometteuses. Cependant, plusieurs questions demeurent non résolues et certaines défis empêchent l'application clinique de la CCT se dans l'IHD, tels que le faible taux de rétention cellulaire in situ, le suivi des cellules in vivo post-implantation et post-acheminements et l`apoptose. Ici, le traitement préliminaire des MSC avec des facteurs de croissance et leur couplage avec des nanoparticules (NP) seront étudiés comme des méthodes pour optimiser MSC. Méthodes: Des MSCs provenant du rat (rMSC) et du cochon (pMSC) ont été isolés à partir de moelle osseuse. Les rMSC ont été préconditionnées avec SDF-1a, TSG-6 et PDGF-BB, et ensuite soumises à une hypoxie, une privation de sérum et a un stress oxydatif. Des études de cicatrisation ont également été effectués avec rMSCs préconditionnées. En parallèle, de nouvelles NP ferromagnétiques liées aux silicones ont été synthétisées. Les NPs ont été couplées aux pMSCs suivant leur fonctionnalisation avec l`anticorps, CD44, un antigène de surface du MSC bien connu. Par la suite, les études de biocompatibilité ont été réalisées sur pMSC-NP et en incluant des tests des processus cellulaires tels que la migration, l'adhésion, la prolifération et les propriétés de la différenciation. Résultats: Parmi toutes les cytokines testées, PDGF-BB a démontré la plus grande capacité à améliorer la survie de MSC dans des conditions d'hypoxie, de privation de sérum et en reponse au stress oxydatif. La conjugaison de NP a atténué la migration et la prolifération des pMSCs, mais n`a pas changé leur capacité de différenciation. Enfin, la complexe du MSC-NP est détectable par IRM. Conclusion: Nos données suggèrent que de nouvelles stratégies, telles que traitement préliminaire de PDGF-BB et le couplage des nanoparticules ferromagnétiques, peuvent être considérés comme des avenues prometteuse pour optimiser les MSCs pour la CCT.

Studies on food and feeding of marine demersal finfishes with special reference to trophic interactions

Food and feeding habits of fourteen demersal finfishes exploited off the Karnataka coast were studied to investigate trophic interactions within the marine food web. Index of Relative Importance (lRI),Ontogenetic, seasonal (pre-monsoon, monsoon and post-monsoon) variation in feeding and prey-predator relationship studies were conducted.The results of prey-predator trophic interaction studies identified four major trophic guilds based on the predators feeding similarity.Trophic guild I is 'copepod and detritus fceders'with an average group similarity of 61.4%. The second trophic guild, 'prawn and crab feeders'with an average similarity of 52.7%. 'Acetes feeders', the largest trophic guild with an average group similarity of 62.5%, composed of six demersal finfish species.The guild 'piscivores' is constituted by C. limba/us and P. arsius with an average similarity of 45%.For each predator, ontogenetic diet shift is common and is characterized by prey of low to high trophic level.Strong selection of certain prey types was observed in some predators while most of them avoided abundant prey.In addition to Acetes spp, strong predation impact was observed for penaeid prawns, epibenthic crabs and detritus.This information on trophic guilds and prey-predator interactions can be used to construct trophic model on the benthic ecosystem off Karnataka and to investigate fishery induced changes as well as predation impact of different animals on commercially important demersals

Studies on nitrifying microorganisms in Cochin Estuary and adjacent coastal waters

This thesis entitled “Studies on Nitrifying Microorganisms in Cochin Estuary and Adjacent Coastal Waters” reports for the first time the spatial andtemporal variations in the abundance and activity of nitrifiers (Ammonia oxidizingbacteria-AOB; Nitrite oxidizing bacteria- NOB and Ammonia oxidizing archaea-AOA) from the Cochin Estuary (CE), a monsoon driven, nutrient rich tropicalestuary along the southwest coast of India. To fulfil the above objectives, field observations were carried out for aperiod of one year (2011) in the CE. Surface (1 m below surface) and near-bottomwater samples were collected from four locations (stations 1 to 3 in estuary and 4 in coastal region), covering pre-monsoon, monsoon and post-monsoon seasons. Station 1 is a low saline station (salinity range 0-10) with high freshwater influx While stations 2 and 3 are intermediately saline stations (salinity ranges 10-25). Station 4 is located ~20 km away from station 3 with least influence of fresh water and is considered as high saline (salinity range 25- 35) station. Ambient physicochemical parameters like temperature, pH, salinity, dissolved oxygen (DO), Ammonium, nitrite, nitrate, phosphate and silicate of surface and bottom waters were measured using standard techniques. Abundance of Eubacteria, total Archaea and ammonia and nitrite oxidizing bacteria (AOB and NOB) were quantified using Fluorescent in situ Hybridization (FISH) with oligonucleotide probes labeled withCy3. Community structure of AOB and AOA was studied using PCR Denaturing Gradient Gel Electrophoresis (DGGE) technique. PCR products were cloned and sequenced to determine approximate phylogenetic affiliations. Nitrification rate in the water samples were analyzed using chemical NaClO3 (inhibitor of nitrite oxidation), and ATU (inhibitor of ammonium oxidation). Contribution of AOA and AOB in ammonia oxidation process was measured based on the recovered ammonia oxidation rate. The contribution of AOB and AOA were analyzed after inhibiting the activities of AOB and AOA separately using specific protein inhibitors. To understand the factors influencing or controlling nitrification, various statistical tools were used viz. Karl Pearson’s correlation (to find out the relationship between environmental parameters, bacterial abundance and activity), three-way ANOVA (to find out the significant variation between observations), Canonical Discriminant Analysis (CDA) (for the discrimination of stations based on observations), Multivariate statistics, Principal components analysis (PCA) and Step up multiple regression model (SMRM) (First order interaction effects were applied to determine the significantly contributing biological and environmental parameters to the numerical abundance of nitrifiers). In the CE, nitrification is modulated by the complex interplay between different nitrifiers and environmental variables which in turn is dictated by various hydrodynamic characteristics like fresh water discharge and seawater influx brought in by river water discharge and flushing. AOB in the CE are more adapted to varying environmental conditions compared to AOA though the diversity of AOA is higher than AOB. The abundance and seasonality of AOB and NOB is influenced by the concentration of ammonia in the water column. AOB are the major players in modulating ammonia oxidation process in the water column of CE. The distribution pattern and seasonality of AOB and NOB in the CE suggest that these organisms coexist, and are responsible for modulating the entire nitrification process in the estuary. This process is fuelled by the cross feeding among different nitrifiers, which in turn is dictated by nutrient levels especially ammonia. Though nitrification modulates the increasing anthropogenic ammonia concentration the anthropogenic inputs have to be controlled to prevent eutrophication and associated environmental changes.

Exaggerated postprandial lipaemia and lower post-heparin lipoprotein lipase activity in middle-aged men

An exaggerated postprandial lipaemic response is thought to play a central role in the development of an atherogenic lipoprotein phenotype, a recognized lipid risk factor for coronary heart disease. A small number of limited studies have compared postprandial lipaemia in subjects of varying age, but have not investigated mechanisms underlying age-associated changes in postprandial lipaemia. In order to test the hypothesis that impaired lipaemia in older subjects is associated with loss of insulin sensitivity, the present study compared the postprandial lipaemic and hormone responses for 9 h following a standard mixed meal in normolipidaemic healthy young and middle-aged men. Lipoprotein lipase (LPL) and hepatic lipase (HL) activities were determined in post-heparin plasma 9 h postprandially and on another occasion under fasting conditions. Postprandial plasma glucose (P < 0.02), retinyl ester (indirect marker for chylomicron particles; P < 0.005) and triacylglycerol (TAG)-rich lipoprotein (density < 1.006 g/ml fraction of plasma) TAG (P < 0.05) and retinyl ester (P < 0.005) responses were higher in middle-aged men, whereas plasma insulin responses were lower in this group (P < 0.001). Fasting and 9 h postprandial LPL and HL activities were also significantly lower in the middle-aged men compared with the young men (P < 0.006). In conclusion, the higher incremental postprandial TAG response in middle-aged men than young men was attributed to the accumulation of dietary-derived TAG-rich lipoproteins (density < 1.006 g/ml fraction of plasma) and occurred in the absence of marked differences in fasting TAG levels between the two groups. Fasting and postprandial LPL and HL activities were markedly lower in middle-aged men, but lack of statistical associations between measures of insulin response and post-heparin lipase activities, as well as between insulin and measures of postprandial lipaemia, suggest that this lower activity cannot be attributed to lack of sensitivity of lipases to activation by insulin. Alternatively, post-heparin lipase activities may not be good markers for the insulin-sensitive component of lipase that is activated postprandially.

Traditional Chinese medicine research in the post-genomic era: good practice, priorities, challenges and opportunities

Background and aims: GP-TCM is the 1st EU-funded Coordination Action consortium dedicated to traditional Chinese medicine (TCM) research. This paper aims to summarise the objectives, structure and activities of the consortium and introduces the position of the consortium regarding good practice, priorities, challenges and opportunities in TCM research. Serving as the introductory paper for the GPTCM Journal of Ethnopharmacology special issue, this paper describes the roadmap of this special issue and reports how the main outputs of the ten GP-TCM work packages are integrated, and have led to consortium-wide conclusions. Materials and methods: Literature studies, opinion polls and discussions among consortium members and stakeholders. Results: By January 2012, through 3 years of team building, the GP-TCM consortium had grown into a large collaborative network involving ∼200 scientists from 24 countries and 107 institutions. Consortium members had worked closely to address good practice issues related to various aspects of Chinese herbal medicine (CHM) and acupuncture research, the focus of this Journal of Ethnopharmacology special issue, leading to state-of-the-art reports, guidelines and consensus on the application of omics technologies in TCM research. In addition, through an online survey open to GP-TCM members and non-members, we polled opinions on grand priorities, challenges and opportunities in TCM research. Based on the poll, although consortium members and non-members had diverse opinions on the major challenges in the field, both groups agreed that high-quality efficacy/effectiveness and mechanistic studies are grand priorities and that the TCM legacy in general and its management of chronic diseases in particular represent grand opportunities. Consortium members cast their votes of confidence in omics and systems biology approaches to TCM research and believed that quality and pharmacovigilance of TCM products are not only grand priorities, but also grand challenges. Non-members, however, gave priority to integrative medicine, concerned on the impact of regulation of TCM practitioners and emphasised intersectoral collaborations in funding TCM research, especially clinical trials. Conclusions: The GP-TCM consortium made great efforts to address some fundamental issues in TCM research, including developing guidelines, as well as identifying priorities, challenges and opportunities. These consortium guidelines and consensus will need dissemination, validation and further development through continued interregional, interdisciplinary and intersectoral collaborations. To promote this, a new consortium, known as the GP-TCM Research Association, is being established to succeed the 3-year fixed term FP7 GP-TCM consortium and will be officially launched at the Final GP-TCM Congress in Leiden, the Netherlands, in April 2012.

Housing supply and brownfield regeneration in a post-Barker world: is there enough brownfield land in England and Scotland?

The findings of the Barker review, which examined the reasons for the undersupply of UK housing, have important implications for the devolved constituents of the UK, including Scotland. This paper traces the emergence of the brownfi eld regeneration policy agenda across the UK and examines how the Barker review connects with this brownfi eld policy focus. The paper compares housing and brownfi eld policies and practices in England and Scotland, places them in an international context and elicits wider lessons for devolved governance in relation to housing policy, in terms of ‘centrist–local’ tensions. Estimates based on published data suggest that Barker’s emphasis on increased housing supply cannot easily be reconciled with the current emphasis on brownfi eld development and is likely to require a return to greenfield development in both countries.

Androgenicity and venous endothelial function in post-menopausal women

Background: Endothelial dysfunction is one of the early signs of cardiovascular damage. High androgen levels have been related to inflammatory endothelial markers in pre- and post-menopausal women. Aim: This cross-sectional study aimed at investigating whether free androgen index (FAI) [estimated by dividing total testosterone (nmol/l) by SHBG (nmol/l) x 100] is related to endothelial function during post-menopause. Subjects and methods: Twenty-six post-menopausal women were assessed with the dorsal hand vein compliance technique. Acetylcholine (Ach) and sodium nitroprusside (SNP) dose-response curves were constructed to test endothelium-dependent and independent relaxation, respectively. Results: Mean age was 54 yr ( 4) and median time since menopause was 6 yr (interquartile range: 3-9). Patients were stratified according to FAI levels into two groups: FAI greater than or less than the group median of 2.5. Waist-to-hip ratio (WHR) was significantly higher in the group with FAI>2.5, as well as median dose of Ach for maximal vasodilation [720 (360-3600) ng/min with FAI>2.5 vs 36 (0.36-360) ng/min with FAI <= 2.5; p=0.005]. Maximal vasodilation with SNP was similar in both groups. Positive correlations were observed between Ach doses and maximal vasodilation and FAI (r=0.473, p=0.015), waist (r=0.510, p= 0.011), and WHR (r=0.479, p=0.021). SHBG was negatively correlated with Ach doses (rs=-0.400, p=0.043). Conclusions: This study suggests that FAI, even within normal limits, is related to early changes in endothelial function in healthy post-menopausal women. Longitudinal studies are required to determine the clinical relevance of these findings. (J. Endocrinol. Invest. 33: 239-243, 2010) (C) 2010, Editrice Kurtis

A review of the scope of scientific studies relating indoor environment and student performance

In 2006-7 the Australian government will invest $9.3 billion in state government and nongovernment educational facilities (DEST 20061). One area of particular interest to both government and school designers is maximising this investment through providing students with healthy and
productive indoor learning environments. The lack of post-occupancy evaluations carried out in schools (Lackney 2001) means that designers are reliant on “best practice” indoor environment quality guidelines developed primarily from scientific studies. The problem with scientific evaluation is that often the complexity of the influences upon student performance is simplified in order to gather information, rather than necessarily providing a more holistic and realistic explanation of any improved outcomes. This paper examines the scope of various studies of classroom indoor environment qualities that have thus far contributed to current understanding of their impact on student learning outcomes. The review demonstrates the lack of comprehensive research into the full range of influences on student performance and offers a better understanding of the limitations of knowledge about indoor environment qualities. This information provides valuable input to research development and post-occupancy evaluation that can better integrate the full range of influences upon students of school facilities and test the assumptions made about “best practice”.

Antenatal dietary patterns and depressive symptoms during pregnancy and early post-partum

Perinatal depression is a debilitating disorder experienced during pregnancy and/or the first year post-partum. Recently, maternal dietary intake during pregnancy has emerged as a possible area of intervention for the prevention of mental disorders in women and their offspring. However, the relationship between antenatal diet quality and perinatal depressive symptoms remains poorly understood. The current study explored the predictive role of antenatal diet quality for antenatal and post-natal depressive symptoms. Pregnant women (n = 167) were recruited between February 2010 and December 2011. Women completed the Edinburgh Postnatal Depression Scale at time 1 [T1, mean weeks gestation = 16.70, standard deviation (SD) = 0.91], time 2 (T2, mean weeks gestation = 32.89, SD = 0.89) and time 3 (T3, mean weeks post-partum = 13.51, SD = 1.97) and a food frequency questionnaire at T1 and T2. Diet quality was determined by extracting dietary patterns via principal components analysis. Two dietary patterns were identified: 'healthy' (including fruit, vegetables, fish and whole grains) and 'unhealthy' (including sweets, refined grains, high-energy drinks and fast foods). Associations between dietary patterns and depressive symptoms were investigated by path analyses. While both 'healthy' and 'unhealthy' path models showed good fit, only one significant association consistent with study hypotheses was found, an 'unhealthy' diet was associated with increased depressive symptoms at 32 weeks gestation. Given that this association was cross-sectional, it was not possible to make any firm conclusions about the predictive nature of either dietary patterns or depressive symptoms. Dietary intervention studies or larger prospective studies are therefore recommended.

Post-decision Processes : Consolidation and value conflicts in decision making

The studies in the present thesis focus on post-decision processes using the theoretical framework of Differentiation and Consolidation Theory. This thesis consists of three studies. In all these studies, pre-decision evaluations are compared with post-decision evaluations in order to explore differences in evaluations of decision alternatives before and after a decision. The main aim of the studies was to describe and gain a clearer and better understanding of how people re-evaluate information, following a decision for which they have experienced the decision and outcome. The studies examine how the attractiveness evaluations of important attributes are restructured from the pre-decision to the post-decision phase; particularly restructuring processes of value conflicts. Value conflict attributes are those in which information speaks against the chosen alternative in a decision. The first study investigates an important real-life decision and illustrates different post-decision (consolidation) processes following the decision. The second study tests whether decisions with value conflicts follow the same consolidation (post-decision restructuring) processes when the conflict is controlled experimentally, as in earlier studies of less controlled real-life decisions. The third study investigates consolidation and value conflicts in decisions in which the consequences are controlled and of different magnitudes. The studies in the present thesis have shown how attractiveness restructuring of attributes in conflict occurs in the post-decision phase. Results from the three studies indicated that attractiveness restructuring of attributes in conflict was stronger for important real-life decisions (Study 1) and in situations in which real consequences followed a decision (Study 3) than in more controlled, hypothetical decision situations (Study 2). Finally, some proposals for future research are suggested, including studies of the effects of outcomes and consequences on consolidation of prior decisions and how a decision maker’s involvement affects his or her pre- and post-decision processes.

The Ingrian Question as a Historical and Political Phenomenon

The project dealt with the political history of the Finnish-speaking minorities of the Russian northwest, mainly in the 20th century. The first part looks at the development of the national movement of the Ingrian Finns and other related ethnic groups (Izhoras, Votes) from the turn of the century to 1920, when Estonia and Finland signed peace treaties with Soviet Russia and the national rights of the Finnish minority in Russia were to some extent guaranteed. In the second section, on the history of the Ingrians during Soviet and post-Soviet times, areas covered include Ingrian national-cultural autonomy in the 1920s, the activities of Ingrian "ingri" organizations in Finland during the inter-war period, social and national repression and the end of autonomy in the 1930s, the dispersal of the Ingrians during the second world war, their first attempts to return home in the immediate post-war period, trends in the development of the social and cultural life of Ingrians during the last 40 years, and the prospects for their existence as an ethnic unity in the future. The research is based on documentary sources from 15 Russian archives, many of which have not previously been used.

Bovine Tuberculosis Risk Factors for British Herds Before and After the 2001 Foot-and-Mouth Epidemic: What have we Learned from the TB99 and CCS2005 Studies?

Over the last couple of decades, the UK experienced a substantial increase in the incidence and geographical spread of bovine tuberculosis (TB), in particular since the epidemic of foot-and-mouth disease (FMD) in 2001. The initiation of the Randomized Badger Culling Trial (RBCT) in 1998 in south-west England provided an opportunity for an in-depth collection of questionnaire data (covering farming practices, herd management and husbandry, trading and wildlife activity) from herds having experienced a TB breakdown between 1998 and early 2006 and randomly selected control herds, both within and outside the RBCT (the so-called TB99 and CCS2005 case-control studies). The data collated were split into four separate and comparable substudies related to either the pre-FMD or post-FMD period, which are brought together and discussed here for the first time. The findings suggest that the risk factors associated with TB breakdowns may have changed. Higher Mycobacterium bovis prevalence in badgers following the FMD epidemic may have contributed to the identification of the presence of badgers on a farm as a prominent TB risk factor only post-FMD. The strong emergence of contact/trading TB risk factors post-FMD suggests that the purchasing and movement of cattle, which took place to restock FMD-affected areas after 2001, may have exacerbated the TB problem. Post-FMD analyses also highlighted the potential impact of environmental factors on TB risk. Although no unique and universal solution exists to reduce the transmission of TB to and among British cattle, there is an evidence to suggest that applying the broad principles of biosecurity on farms reduces the risk of infection. However, with trading remaining as an important route of local and long-distance TB transmission, improvements in the detection of infected animals during pre- and post-movement testing should further reduce the geographical spread of the disease.

Neuromuscular disuse and atrophy: {\it In vivo\/} magnetic resonance studies of intramuscular lipid metabolism and fluid shift changes

We postulated that neuromuscular disuse results in deleteriously affected tissue-vascular fluid exchange processes and subsequently damages the important oxidative bioenergetic process of intramuscular lipid metabolism. The in-depth research reported in the literature is somewhat limited by the ex vivo nature and sporadic time-course characterization of disuse atrophy and recovery. Thus, an in vivo controlled, localized animal model of disuse atrophy was developed in one of the hindlimbs of laboratory rabbits (employing surgically implanted tetrodotoxin (TTX)-filled mini-osmotic pump-sciatic nerve superfusion system) and tested repeatedly with magnetic resonance (MR) throughout the 2-week period of temporarily induced disuse and during the recovery period (following explantation of the TTX-filled pump) for a period of 3 weeks. Controls consisted of saline/"sham"-implanted rabbit hindlimbs. The validity of this model was established with repeated electrophysiologic nerve conduction testing using a clinically appropriate protocol and percutaneously inserted small needle stimulating and recording electrodes. Evoked responses recorded from proximal (P) and distal (D) sites to the sciatic nerve cuff in the TTX-implanted group revealed significantly decreased (p $<$ 0.001) proximal-to-distal (P/D) amplitude ratios (as much as 50-70% below Baseline/pre-implanted and sham-implanted group values) and significantly increased (p $<$ 0.01) differential latency (PL-DL) values (as much as 1.5 times the pre- and sham-implanted groups). By Day 21 of recovery, observed P/D and PL-DL levels matched Baseline/sham-implemented levels. MRI-determined cross-sectional area (CSA) values of Baseline/pre-implanted, sham- or TTX-implanted, and recovering/explanted and the corresponding contralateral hindlimb tibialis anterior (TA) muscles normalized to tibial bone (TB) CSA (in TA/TB ratios) revealed that there was a significant decline (indicative of atrophic response) from pre- and sham-implanted controls by as much as 20% (p $<$ 0.01) at Day 7 and 50-55% (p $<$ 0.001) at Day 13 of TTX-implantation. In the non-implanted contralaterals, a significant increase (indicative of hypertrophic response) by as much as 10% (p $<$ 0.025) at Day 7 and 27% (p $<$ 0.001) at Day 13 + TTX was found. The induced atrophic/hypertrophic TA muscles were observed to be fully recovered by Day 21 post-explantation as evidenced by image TA/TB ratios. End-point biopsy results from a small group of rabbits revealed comprehensive atrophy of both Type I and Type II fibers, although the heterogeneity of the response supports the use of image-guided, volume-localized proton magnetic resonance spectroscopy (MRS) to noninvasively assess tissue-level metabolic changes. MRS-determined results of a 0.25cc volume of tissue within implanted limb TA muscles under resting/pre-ischemic, ischemic-stressed, and post-ischemic conditions at timepoints during and following disuse atrophy/recovery revealed significantly increased intramuscular spectral lipid levels, as much as 2-3 times (p $<$ 0.01) the Baseline/pre-implanted values at Day 7 and 6-7 times (p $<$ 0.001) at Day 13 + TTX, which approached normal levels (compared to pre- and sham-implanted groups) by Day 21 of post-explanation recovery. (Abstract shortened by UMI.) ^

Hormonal and Clinical Predictors for Post-egg Retrieval Pain in Women Undergoing Assisted Reproductive Technology Procedures

OBJECTIVES The intensity of post-egg retrieval pain is underestimated, with few studies examining post-procedural pain and predictors to identify women at risk for severe pain. We evaluated the influence of pre-procedural hormonal levels, ovarian factors, as well as mechanical temporal summation (mTS) as predictors for post-egg retrieval pain in women undergoing in vitro fertilization (IVF). METHODS Eighteen women scheduled for ultrasound-guided egg retrieval under standardized anesthesia and post-procedural analgesia were enrolled. Pre-procedural mTS, questionnaires, clinical data related to anesthesia and the procedure itself, post-procedural pain scores and pain medication for breakthrough pain were recorded. Statistical analysis included Pearson product moment correlations, Mann-Whitney U tests and multiple linear regressions. RESULTS Average peak post-egg retrieval pain during the first 24 hours was 5.0±1.6 on an NRS scale (0=no pain, 10=worst pain imaginable). Peak post-egg retrieval pain was correlated with basal antimullerian hormone (AMH) (r=0.549, P=0.018), pre-procedural peak estradiol (r=0.582, P=0.011), total number of follicles (r=0.517, P=0.028) and number of retrieved eggs (r=0.510, P=0.031). Ovarian hyperstimulation syndrome (OHSS) (n=4) was associated with higher basal AMH (P=0.004), higher peak pain scores (P=0.049), but not with peak estradiol (P=0.13). The mTS did not correlate with peak post-procedural pain (r=0.266, P=0.286), or peak estradiol level (r=0.090, P=0.899). DISCUSSION Peak post-egg retrieval pain intensity was higher than anticipated. Our results suggest that post-egg retrieval pain can be predicted by baseline AMH, high peak estradiol, and OHSS. Further studies to evaluate intra- and post-procedural pain in this population are needed, as well as clinical trials to assess post-procedural analgesia in women presenting with high hormonal levels.