From telescope to binoculars. Dyadic outcome resulting from psychological counselling for infertile couples undergoing ART

Objective: This longitudinal study aims to evaluate the effect of psychological counselling on quality of life, marital satisfaction and need for parenthood in couples undergoing fertility treatments (ART).

Background: Recent guidelines on the ART suggest that psychological counselling should target both members of the infertile couple in order to improve their conjoint management of the infertility-related stress. However, studies on the dyadic outcome of couples are scarce.

Methods: 262 patients were originally considered in the study and completed questionnaires on quality of life, need for parenthood and marital satisfaction, before treatment (T1) and at the day of intrauterine insemination/embryo transfer (T2). For the purposes of this study, 34 counselled couples were then matched to 34 non-counselled couples by propensity scores. The Common Fate Model (CFM) was used to examine dyadic changes.

Results: Couples receiving counselling had higher dyadic quality of life and lower dyadic stress due to the need for parenthood at T2 compared to non-counselled couples. No differences were found on marital satisfaction.

Conclusion: The findings provide support for the effectiveness of counselling on interpersonal outcome. The CFM allows researchers to examine how the dyad as a whole responds to counselling, highlighting the change in the couple’s relational dynamics.     

Care Quality and Spending Among Commercially Insured Children With Disabilities

Objective

To identify opportunities to improve care value for children with disabilities (CWD), we examined CWD prevalence within a commercially insured population and compared outpatient care quality and annual health plan spending levels for CWD relative to children with complex medical conditions without disabilities; children with chronic conditions that are not complex; and children without disabling, complex, or chronic conditions.

Motor learning in children with spina bifida: dissociation between performance level and acquisition rate.

The cerebellum is part of a neural circuit involved in procedural motor learning. We examined how congenital cerebellar malformations affect mirror drawing performance, a procedural learning task that involves learning to trace the outline of a star while looking at the reflection of the star in a mirror. Participants were 88 children with spina bifida myelomeningocele, a neural tube defect that results in lesions of the spinal cord, dysmorphology of the cerebellum, and requires shunt treatment for hydrocephalus, and 35 typically developing controls. Participants completed 10 trials in the morning and 10 trials following a 3-hr delay. Although children with spina bifida myelomeningocele were initially slower at tracing and made more errors than controls, all participants improved their performance of the task, as demonstrated by increased speed and accuracy across trials. Moreover, degree of cerebellar dysmorphology was not correlated with level of performance, rate of acquisition, or retention of mirror drawing. The results suggest that congenital cerebellar dysmorphology in spina bifida does not impair motor skill learning as measured by acquisition and retention of the mirror drawing task.     

Identifying dimensions of performance in local public health systems: results from the National Public Health Performance Standards Program.

This article uses data from the National Public Health Performance Standards Program to explore how the performance of essential public health services varies across communities and to identify underlying domains of activity that appear to drive variation in performance. Cross-sectional data were used from 315 local public health jurisdictions located within seven states that participated in the Performance Standards Program pilot tests between 1999 and 2001. Results demonstrate that local public health systems vary considerably in the extent to which they perform essential services and meet established performance standards. Factor analysis results indicate that four underlying domains of activity explain much of the variation observed in the individual performance measures, and that achieving performance standards for a single essential public health service often involves more than one underlying domain of activity. The findings suggest that composite measures constructed from the Performance Standards Program can assist public health decision makers in monitoring the performance of public health systems and identifying promising pathways for improving performance.     

Movement‐based feedback may reduce spinal moments in male workers during lift and lowering tasks

Background and Purpose . To assess if lifting performance can be modified and spine stresses reduced in workers who perform repetitive material‐handling jobs in a warehouse environment via a novel real‐time, movement‐based feedback training protocol. Method . A pre‐test/post‐test group study design was used with a control group. Data were collected in a warehouse setting and analysed in a university setting. A convenience sample of 22 male warehouse employees was divided equally, based on height and weight, and assigned to either an experimental group or a control group. The experimental group received real‐time, performance‐based auditory feedback from their calculated moments during lifting or lowering using an electromagnetic tracking system. The electromagnetic tracking system was used to measure the side‐bending, flexion and rotation moments during six lifts under four different conditions. A series of repeated‐measures analyses of variance (ANOVA) (one between (Group); one within (Time)) was performed on the average maximum moments from six lifting or lowering cycles for all three directions: side‐bending, flexion and rotation. Results . There were significant group X time interactions for the side‐bending moment (p < 0.05) and the flexion moment (p < 0.05) but not the rotation moment (p > 0.05). Lower moments were found in the experimental group, which received the training and feedback, compared to the control group. Conclusions . Real‐time, auditory feedback combined with coaching during lifting or lowering tasks may be effective in the short term (six weeks) in reducing the average maximum side‐bending and flexion moments in warehouse workers. Further research is needed to determine the long‐term effects of this training protocol on low back injury rates. Copyright © 2006 John Wiley & Sons, Ltd.