Administration of low-molecular-weight heparin in patients with two or more unsuccessful IVF/ICSI cycles: a multicenter cohort study

To compare the effects of the administration of low-molecular-weight heparin (LMWH) in subfertile patients with two or more unsuccessful IVF/ICSI cycles. In this six-center two-arm retrospective cohort study, the study population (230 women) underwent a GnRH-antagonist protocol and was classified into two groups, according to the couse of LMWH or not. Groups were compared regarding the clinical and IVF/ICSI cycle characteristics and reproductive outcomes, whereas clinical pregnancy and miscarriage constituted the primary endpoints. Logistic regression analysis was performed to determine the potential predictors of clinical pregnancy, miscarriage and live birth rates using the Enter method. Baseline characteristics were comparable in the two groups. There was no statistically significant difference between the two study groups with regard neither to clinical pregnancy and miscarriage rates (33/133 vs. 20/97, p?=?.456 and 15/133 vs. 9/97, p?=?.624, respectively), nor to the secondary outcomes preset for this study (all p values?>.05). Logistic regression revealed that age of the woman and ICSI and dose of gonadotrophins used were predictors of clinical pregnancy and live birth, respectively. In conclusion, there is no evidence to support the standard addition of LMWH in patients with two or more unsuccessful IVF/ICSI cycles.     

Research Priorities for Healthcare Chaplaincy: Views of U.S. Chaplains

Chaplains in the United States and around the world appear to support an evidence-based practice approach to chaplaincy. While there continues to be strong growth in spiritual care research, several spiritual care researchers have stressed the need for a research agenda for chaplaincy. This study investigated the research priorities of chaplains who completed a survey distributed at four chaplaincy conferences in 2016. A total of 193 chaplains responded, resulting in 499 comments. When compared to the findings of existing literature regarding research priorities for chaplaincy, chaplain’s views of research priorities appear to be very consistent with views of chaplaincy leaders. Both prioritize research on outcomes of spiritual care, the development and testing of the effectiveness of interventions, the development and evaluation of assessment and screening tools and research about key subgroups of patients. The chaplains in the survey however added to the agenda research regarding competencies, education, and certification and research regarding the chaplain and the team.