Factors that influence infertile couples’ selection of reproductive medicine centers---A cross-sectional questionnaire study

ObjectiveThe number of infertile women undergoing in vitro fertilization (IVF) cycles has increased annually. Due to this competitive environment, we designed a questionnaire and aimed to investigate factors affecting the choice of reproductive medicine center among infertile couples.Materials and methodsThis was a retrospective cross-sectional study that analyzed questionnaires provided by the reproductive medicine center of the Kaohsiung Veterans General Hospital from January 2018 to June 2018. In the questionnaire, there are six categories (environment and equipment, service quality, patient safety, medical quality, information acquisition channel and other) and 36 items. The identified factors were scored and then weighted using principal component analysis.ResultsMost of the 100 identified infertile women were aged 31–35 years, were married 1–3 years, and had a university education level. In the weight analysis, “Clean outpatient clinic and medical equipment” had the greatest weight in the dimension of environment and equipment. The item with the greatest weight in the dimension of service quality was “Waiting time for registration, charging, and receiving medicine”. In the dimension of patient safety, “Privacy is highly respected by medical personnel” had the highest weight. The item with the greatest weight in the dimension of medical quality was “Success rate of reproductive medicine center”. The three items with the highest weights in the dimension of information acquisition channel were “Newspapers and magazines”, “TV media”, and “Facebook page and website of our hospital”. In the other dimensions, the two with the greatest weights were “Reputation of the hospital” and “Reputation of physicians”.ConclusionIn the infertile couples' view, optimal reproductive medicine centers should have a high success rate and great reputation on the internet and in mass media. Additionally, a short waiting time and high levels of privacy and confidentiality are also imperative.     

Sexual training needs assessment in the Highlands of Scotland

This report outlines the results from a needs assessment survey across a range of agencies in the Highlands of Scotland, including schools, general practices, community nursing, social work and community education. The survey was conducted in order to assess what professionals' needs are for training in sexual health. The methodology used was questionnaire and follow-up interviews. The response rate to the questionnaire was 47%, with 85% considering there was a need for training in their organization. The questionnaire analysis and qualitative interviews highlighted young people as a particular concern for professionals in all agencies. The recommendations are that training programmes are offered in two phases: first-phase training for staff who are early entrants to sexual health work, and second-phase training for staff who have some experience or who need updates or information on new approaches and developments.     

不良孕产史夫妇染色体核型的大样本分析

目的探讨不良孕产史夫妇染色体异常核型检出率及其分布，以及染色体异常核型与不良孕产史的关系，为优生优育及遗传咨询提供理论依据。 方法选取2016年1月1日至2017年12月31日，于济南艾迪康医学检验中心进行染色体核型检测的10 330对(20 660例)不良孕产史育龄夫妇为研究对象。采集每例受试者肘静脉血3 mL，肝素钠抗凝，取0.3 mL进行血细胞培养、标本制备，采用常规G显带技术进行染色体核型分析。对于染色体异常核型检出率、不同类型染色体异常核型占染色体异常核型总例数的比例等计数资料，采用率(%)表示。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。 结果①本组10 330对(20 660例)不良孕产史育龄夫妇中，共计检出染色体异常核型为1 119例(不含染色体多态性)，染色体异常核型检出率为5.42%(1 119/20 660)。其中，常染色体异常者为658例，占染色体异常核型的58.80%(658/1 119)，包括354例染色体平衡易位、205例染色体倒位、83例染色体罗伯逊易位、11例染色体插入、5例染色体重复，分别占染色体异常核型的31.64%、18.32%、7.41%、0.98%、0.45%。染色体倒位者中，以9号染色体倒位居多，偶见于1、4、7、11、12号染色体，并且多合并自然流产。性染色体异常者为440例，占染色体异常核型的39.32%(440/1 119)，包括365例性染色体数目异常(占染色体异常核型的32.62%)。其中，男性多表现为无精子症，以47，XXY染色体异常核型居多(144例)，女性多表现为原发性不孕，以45，X染色体异常核型居多(103例); 61例为性染色体结构异常、14例为性别反转，分别占染色体异常核型的5.45%、1.25%。其他罕见染色体异常核型者为21例，占染色体异常核型的1.88%(21/1 119)，如环状染色体、mar染色体等。②本组10 330对(20 660例)不良孕产史育龄夫妇中，11例为常染色体插入，5例为常染色体重复，54例为性染色体缺失，其主要临床表现为原发性不孕不育、胚胎停止发育、无精子症或重度少精子症。 结论染色体异常核型是导致育龄期夫妇不良孕产史的重要原因之一。对于不良孕产史夫妇，建议进行染色体核型分析和遗传咨询。临床为这类患者进行优生优育指导，可提高出生人口质量。     

A Problem-Solving Strategy and Self-Esteem in Recovering Chemically Dependent Women

The primary purpose of the study was to determine the effectiveness of a problem-solving strategy intervention in raising the self-esteem of recovering women. An A-B-A single subject design was employed in the investigation. Self-esteem was measured by: pre-intervention and post-intervention administrations of the Tennessee Self-Concept Scale, the percentage of positive self-statements recorded in journal entries, and self-ratings of decision-making ability. Of the four subjects who participated in the study, three experienced an increase in self-esteem.     

Promoting Resilience Following Traumatic Brain Injury: Application of an Interdisciplinary,Evidence‐Based Model for Intervention

With an increasing instance of traumatic brain injury and little advancement over recent decades in the rehabilitation of brain injury survivors and their family members, focus has shifted toward the establishment of effective whole‐family resilience promotion interventions. Using the Brain Injury Family Intervention as a model, clinicians constructed two curriculum‐based interventions grounded in resilience theory and drawing from the interdisciplinary approaches of neuropsychology and marriage and family therapy: (a) the Resilience and Adjustment Intervention, for individual survivors of traumatic brain jury, and (b) the Therapeutic Couples Intervention, designed to increase relational satisfaction in couples following a traumatic brain injury. The present study outlines the need for the integration of resilience tenets into rehabilitation techniques, summarizes the empirical justification for the use of an interdisciplinary approach, and offers an overview with implementation specifics regarding these two newly designed interventions.     

惠州市同型α地中海贫血夫妇的胎儿产前地贫基因诊断分析

目的研究惠州市同型α地贫夫妇的胎儿地贫发生率、基因突变类型和分布特点,为制订本地区地贫的防治工作计划提供科学依据。方法 154对夫妇均为轻型α地中海贫血基因携带者,在孕早期取胎儿绒毛组织,孕中期取脐血或羊水,孕晚期取脐血;对羊水细胞和绒毛组织进行原位培养,脐血进行血液学和血红蛋白分析,分别采用培养前后的组织或脐血进行α地中海贫血基因检测。结果在154例胎儿中,检出重型α地中海贫血胎儿18例,检出率为11.69%;检出α地贫携带者75例,检出率为48.70%;检出缺失型HbH病9例,检出率为5.84%;检出正常胎儿50例,检出率为32.47%;检出纯合子和双重杂合子各1例。结论本研究描述了惠州市同型α地贫夫妇的胎儿α地贫的发生率,基因突变类型和分布特点,为制订本地区地贫的防治工作计划提供科学依据。     

惠州市同型β地中海贫血夫妇的胎儿产前地贫基因诊断分析

目的研究惠州市同型β地贫夫妇的胎儿地贫携带率、基因突变类型和分布特点。方法 116对夫妇均为轻型β-地中海贫血基因突变者,在孕早期取胎儿绒毛组织,孕中期取脐血或羊水,孕晚期取脐血;对羊水细胞和绒毛组织进行原位培养,脐血进行血液学和血红蛋白分析,分别采用培养前后的组织或脐血进行β地中海贫血基因检测。结果 116例胎儿中检出重型β-地中海贫血胎儿27例(23.28%);检出地贫携带者56例(48.28%)。共检出11种突变基因,21种基因型,居前4位的依次是:CD41-42(26.51%)(22/27+56)、IVS-Ⅱ-654(14.46%)(12/27+56)、CD-28(10.84%)(9/27+56),CD17(6.02%)(5/27+56);其中,单突变杂合子9种,56例(67.47%)(56/27+56),双突变杂合子10种,24例(28.92%)(24/27+56),突变纯合子2种,3例(3.61%)(3/27+56),另外,检出少见位点突变CD14-15和CD41-42/43各1例。结论本研究描述了惠州市同型β地贫夫妇的胎儿地贫的发生率和基因突变谱,为制订本地区地贫的防治工作提供科学依据。     

Observations on heredity and obesity in the emergence of diabetes

Summary The 899 offspring of Natal Indian diabetic couples are compared with the general Indian population. Diabetes was present in 25% of offspring aged 40– 49 as against 14.7% of the general population. The ratio of offspring diabetics to population diabetics diminished with age, suggesting that the genetic influence affects mainly age of onset of diabetes. Old and young diabetic couples had a similar proportion of diabetic children. Another similar comparison could be made between an inbred Tamil Indian family in Cape Town and the general population of Cape Hindus. More young diabetics were obese than old diabetics, in3 different racial groups and in both clinic and survey diabetics, whereas in the general population obesity is more common over age 40. Overweight may be a more important diabetes risk factor in young than in old people.

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Beobachtungen über Erblichkeit und Fettleibigkeit beim Auftreten des Diabetes

Zusammenfassung Eine Gruppe von 899 Indern aus Natal, Nachkommen diabetischer Elternpaare, wurde mit der indischen Gesamtbevölkerung in Natal verglichen. Diabetes wurde in 25% der Nachkommen im Alter zwischen 40 und 49 Jahren beobachtet, verglichen mit 14.7% in der Gesamtbevölkerung. Die Verhältniszahl: Diabetiker unter den Nachkommen zu den Diabetikern in der Gesamtbevölkerung verringerte sich mit ansteigendem Alter; dieser Befund scheint anzudeuten, daß ein möglicher genetischer Faktor einen besonderen Einfluß auf das Alter ausübt, in dem der Diabetes sich manifestiert. Alte und junge Elternpaare hatten eine ähnliche zahlenmäßige Verteilung diabetischer Kinder. Ein ähnlicher Vergleich konnte zwischen einer Familiengruppe indischer Tamilen in Kapstadt und der gesamten HinduBevölkerung' von Kapstadt angestellt werden. Bei drei rassisch verschiedenen Bevölkerungsgruppen und bei klinischen wie bei neuentdeckten Diabetikern wurde festgestellt, daß Fettleibigkeit häufiger bei jungen als bei alten Diabetikern auftrat, während in der Gesamtbevölkerung die Fettleibigkeit im Alter von über 40 Jahren häufiger war. Übergewicht ist ais Risikofaktor für den Diabetes vielleicht wichtiger bei jüngeren als bei älteren Personen.

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Observations sur l'hérédité et l'obésité dans l'apparition du diabèté

Résumé 899 enfants nés de couples Indiens diabétiques (province du Natal) ont été comparés à l'ensemble de la population indienne. Le diabète était présent chez 25% des descendants âgés entre 40 et 49 ans contre 14.7% pour la population générale. La différence de prévalence du diabète entre les descendants des couples diabétiques et la population générale diminuait avec l'âge, ce qui semble indiquer que le facteur génétique affecte surtout l'âge d'apparition du diabète. La proportion d'enfants diabétiques était identique pour les couples diabétiques jeunes ou vieux. Cette même comparaison a pu se faire entre une famille indienne Tamil dont les membres s'épousent entre eux et vivant au Cap et l'ensemble de la population indienne du Cap. La prévalence d'obésité était plus grande chez les diabétiques jeunes que chez les diabétiques âgés dans trois groupes raciaux différents et ceci aussi bien pour le diabète symptomatique qu' asymptomatique; par contre l'obésité est plus fréquente pour la population générale dépassant l'âge de 40 ans. L'obésité semble jouer un rôle plus important comme facteur diabétogène chez les jeunes que chez les personnes âgées.