scholarly journals The stepwise development of an interactive web-based sex education programme for subfertile couples: the Pleasure & Pregnancy programme

2020 ◽  
Vol 35 (8) ◽  
pp. 1839-1854
Author(s):  
F Dreischor ◽  
E T M Laan ◽  
S Apers ◽  
S Repping ◽  
R H W van Lunsen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Pregnancy Rate ◽  
Sex Education ◽  
Sexual Functioning ◽  
Expectant Management ◽  
Education Programme ◽  
Pregnancy Rates ◽  
Sexual Pleasure ◽  
Web Based ◽  
Mrc Framework

Abstract STUDY QUESTION Can we develop a web-based sex education programme (programme running in a web browser) that addresses the needs of subfertile couples who are advised expectant management for at least 6 months? SUMMARY ANSWER The ‘Pleasure & Pregnancy’ programme addresses couples’ needs, is likely to improve couples’ sexual functioning, and is subsequently hypothesised to improve the chance of natural pregnancy. WHAT IS KNOWN ALREADY According to professional guidelines (e.g. the Netherlands and UK) couples with unexplained subfertility and a good chance of natural pregnancy, should be advised at least 6 months of expectant management. Adherence to expectant management is challenging as couples and gynaecologist prefer a more active approach. Targeting sexuality may be useful as subfertility is a risk factor for decreased sexual functioning. STUDY DESIGN, SIZE, DURATION A novel programme was developed according to the three steps of the Medical Research Councils’ (MRC) framework. First, relevant literature was explored. Second, an interdisciplinary expert panel developed a theory (based on a systematic literature review and patient interviews) on how the chance of natural conception can be improved. Third, the expected process and outcomes were modelled. PARTICIPANTS/MATERIALS, SETTING, METHODS Two licenced clinical sexologists, two gynaecologists, a clinical embryologist and two midwife-researchers, all from Belgium and the Netherlands, proposed components for the sex education programme. PubMed was searched systematically for randomised controlled trials (RCTs) evaluating the proposed components in different patient populations. The needs of 12 heterosexual Dutch or Belgian couples who were advised expectant management were explored with in-depth interviews. The content and delivery characteristics of the novel programme were described in detail with the aid of ‘Intervention Taxonomy’. To model the outcomes, a protocol for an RCT was designed, registered and submitted for publication. MAIN RESULTS AND THE ROLE OF CHANCE To help maintain or improve sexual functioning, mainly pleasure, and hence increase pregnancy rates, the web-based Pleasure & Pregnancy programme contains a combination of psychosexual education and couple communication, mindfulness and sensate focus exercises. Information on the biology of conception and interaction with fertility clinic staff and peers were added based on couples’ needs to increase potential acceptability. LIMITATIONS AND REASON FOR CAUTION This paper outlines the development phase of a sex education programme according to the MRC-framework. Whether the Pleasure & Pregnancy programme actually is acceptable, improves sexual functioning, increases pregnancy rates and is cost-effective remains to be determined. WIDER IMPLICATIONS OF THE FINDINGS No previous interactive web-based sex education programme has aimed to increase the natural pregnancy rate of subfertile couples by targeting their sexual pleasure. The Pleasure & Pregnancy programme addresses couples’ needs and its effect on sexual functioning and pregnancy rate is plausible but remains to be demonstrated by an RCT which is currently ongoing. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by The Netherlands Organisation for Health Research and Development (ZonMw), Flanders Research Foundation and the University of Amsterdam. C.B.L. is editor-in-chief of Human Reproductionbut was blinded to all parts of the peer review process. The remaining authors have no conflict of interest to report. TRIAL REGISTRATION NUMBER Not applicable.

scholarly journals The ‘Pleasure&Pregnancy’ web-based interactive educational programme versus expectant management in the treatment of unexplained subfertility: protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025845 ◽  
Author(s):  
Eline A F Dancet ◽  
Thomas M D’Hooghe ◽  
Felicia Dreischor ◽  
Madelon van Wely ◽  
Ellen T M Laan ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Sexual Functioning ◽  
Controlled Trial ◽  
Expectant Management ◽  
Good Prognosis ◽  
Educational Programme ◽  
Ongoing Pregnancy ◽  
Web Based ◽  
Face To Face ◽  
Randomised Controlled

IntroductionMany subfertile couples are diagnosed with (relatively) unexplained subfertility and a good prognosis. National professional guidelines (eg, the Netherlands and UK) advise ‘expectant management (EM)’ for 6–12 months, in which no interaction with healthcare staff is offered. Underpowered studies indicate that face-to-face sex-counselling increases the ongoing pregnancy rates of these couples. In patients with other conditions, web-based interactive educational programmes have the same effect on sexual functioning as face-to-face sex counselling. The ‘Pleasure&Pregnancy randomised controlled trial (RCT)’ will examine in couples with unexplained subfertility and a good prognosis whether a new web-based interactive educational programme results in a higher chance of naturally conceiving an ongoing pregnancy within 6 months as compared with EM.Methods and analysisA multicentre RCT with cost-effectiveness analysis will include heterosexual couples diagnosed with (relatively) unexplained subfertility and a good prognosis in Dutch and Belgian secondary or tertiary fertility clinics. Couples will be randomised between 6 months of EM and 6 months of the Pleasure&Pregnancy-programme. This new web-based interactive educational programme includes eight progressive modules of information (on the biology of conception and pleasurable sex) and sensate focus, couple communication and mindfulness exercises. Couples are offered interaction with their coaches via email and can take part in three moderated chat sessions with peers. The primary outcome of this RCT is the probability of naturally conceiving an ongoing pregnancy within 6 months after randomisation. Secondary outcomes include time-to-pregnancy, live birth rate, costs, sexual functioning and personal and relational well-being. Analysis will be according to intention to treat.Ethics and disseminationThis study has been approved by the Medical Ethical Committees of the Academic Medical Centre (the Netherlands) and the Leuven University Hospital (Belgium). The findings of this RCT will be disseminated through presentations at international scientific meetings and peer-reviewed publications.Trail registration numberNTR5709; Pre-results.

Hormonal stimulation and some risk factors studied to improve bovine pregnancy rate at the Coastal areas of Barisal district of Bangladesh

2018 ◽  
Vol 52 (1-4) ◽  
pp. 22-30
Author(s):  
A K Paul ◽  
S M T Rahman
Keyword(s):  
Pregnancy Rate ◽  
Coastal Region ◽  
Hormonal Treatment ◽  
Coastal Areas ◽  
Pregnancy Rates ◽  
Hormonal Stimulation ◽  
Crossbred Cows ◽  
Treatment Groups ◽  
History Of ◽  
Group A

Hormonal treatment of cows at the coastal region of Barisal district of Bangladesh was performed to assess the improvement of pregnancy rate. A total of 100 cows and heifers with irregular history of cyclicity were selected randomly and divided into five treatment groups. The groups were A (treated with anthelmintic), B (treated with anthelmintic, vitamin ADE and multivitamin powder), C (treated with PGF2α), D (treated with GnRH) and E (treated with GnRH and PGF2α). Each group comprised of 20 animals. The age, breed and parity of experimental cows were considered during treatment. In the study, the cows treated with both GnRH and PGF2α (group E) showed significantly (p<0.05) higher estrus (80%) and pregnancy rate (60%) than that of group A, B, C and D. The overall estrus rates of local and crossbred cows were 64% and 70%, respectively and the pregnancy rates were 40 and 52%, respectively. The crossbred cows responded significantly (p<0.05) to hormonal treatment than that of local cows. Parity-2 cows showed higher estrus sign than that of other parities. However, the pregnancy rates were higher significantly (p<0.05) in parity-2 and parity ≥4 cows than that of parity-0, parity-1 and parity-3 cows. The pregnancy rate was also found higher in case of 4 to <5 years old cows than that of 2 to <3, 3 to <4, 5 to <6, and ≥6 years old. It may conclude that the hormonal regimen increases the pregnancy rate as well as decreases the undesired waiting of estrus and conception. Further study with more sample size will reveal the more effective treatment for cows at the coastal areas of Bangladesh.

Hormonal stimulation and some risk factors studied to improve bovine pregnancy rate at the Coastal areas of Barisal district of Bangladesh

2018 ◽  
Vol 52 (1-4) ◽  
pp. 22-30
Author(s):  
A K Paul ◽  
S M T Rahman
Keyword(s):  
Pregnancy Rate ◽  
Coastal Region ◽  
Hormonal Treatment ◽  
Coastal Areas ◽  
Pregnancy Rates ◽  
Hormonal Stimulation ◽  
Crossbred Cows ◽  
Treatment Groups ◽  
History Of ◽  
Group A

Hormonal treatment of cows at the coastal region of Barisal district of Bangladesh was performed to assess the improvement of pregnancy rate. A total of 100 cows and heifers with irregular history of cyclicity were selected randomly and divided into five treatment groups. The groups were A (treated with anthelmintic), B (treated with anthelmintic, vitamin ADE and multivitamin powder), C (treated with PGF2α), D (treated with GnRH) and E (treated with GnRH and PGF2α). Each group comprised of 20 animals. The age, breed and parity of experimental cows were considered during treatment. In the study, the cows treated with both GnRH and PGF2α (group E) showed significantly (p<0.05) higher estrus (80%) and pregnancy rate (60%) than that of group A, B, C and D. The overall estrus rates of local and crossbred cows were 64% and 70%, respectively and the pregnancy rates were 40 and 52%, respectively. The crossbred cows responded significantly (p<0.05) to hormonal treatment than that of local cows. Parity-2 cows showed higher estrus sign than that of other parities. However, the pregnancy rates were higher significantly (p<0.05) in parity-2 and parity ≥4 cows than that of parity-0, parity-1 and parity-3 cows. The pregnancy rate was also found higher in case of 4 to <5 years old cows than that of 2 to <3, 3 to <4, 5 to <6, and ≥6 years old. It may conclude that the hormonal regimen increases the pregnancy rate as well as decreases the undesired waiting of estrus and conception. Further study with more sample size will reveal the more effective treatment for cows at the coastal areas of Bangladesh.

scholarly journals Test–retest reliability of the EQ-5D-5L and the reworded QOLIBRI-OS in the general population of Italy, the Netherlands, and the United Kingdom

2021 ◽  
Author(s):  
Di Long ◽  
Suzanne Polinder ◽  
Gouke J. Bonsel ◽  
Juanita A. Haagsma
Keyword(s):  
United Kingdom ◽  
General Population ◽  
The Netherlands ◽  
Web Based ◽  
Retest Reliability ◽  
The United Kingdom ◽  
Sum Score ◽  
Summary Index ◽  
Test Retest Reliability ◽  
Eq Vas

Abstract Purpose To assess the test–retest reliability of the EQ-5D-5L and the reworded Quality of Life After Traumatic Brain Injury Overall Scale (QOLIBRI-OS) for the general population of Italy, the Netherlands, and the United Kingdom (UK). Methods The sample contains 1864 members of the general population (aged 18–75 years) of Italy, the Netherlands, and the UK who completed a web-based questionnaire at two consecutive time points. The survey included items on gender, age, level of education, occupational status, household annual income, chronic health status, and the EQ-5D-5L and reworded QOLIBRI-OS instrument. Test–retest reliability of the EQ-5D-5L dimensions, EQ-5D-5L summary index, EQ VAS, reworded QOLIBRI-OS dimensions and reworded QOLIBRI-OS level sum score was examined by Gwet’s Agreement Coefficient (Gwet’s AC) and Intraclass Correlation Coefficient (ICC). Results Gwet’s AC ranged from 0.64 to 0.97 for EQ-5D-5L dimensions. The ICC ranged from 0.73 to 0.84 for the EQ-5D-5L summary index and 0.61 to 0.68 for EQ VAS in the three countries. Gwet’s AC ranged from 0.35 to 0.55 for reworded QOLIBRI-OS dimensions in the three countries. The ICC ranged from 0.69 to 0.77 for reworded QOLIBRI-OS level sum score. Conclusion Test–retest reliability of the EQ-5D-5L administered via a web-based questionnaire was substantial to almost perfect for the EQ-5D-5L dimensions, good for EQ-5D-5L summary index, and moderate for the EQ VAS. However, test–retest reliability was less satisfactory for the reworded QOLIBRI-OS. This indicates that the web-based EQ-5D-5L is a reliable instrument for the general population, but further research of the reworded QOLIBRI-OS is required.

scholarly journals Process evaluation of the ACTION programme: a strategy for implementing person‐centred communication in home care

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Home Care ◽  
Process Evaluation ◽  
Organizational Support ◽  
Qualitative Data ◽  
Education Programme ◽  
Multiple Sources ◽  
Web Based ◽  
Action Programme ◽  
Web Based Education ◽  
The Web

Abstract Background There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary ().

P–131 Significance of the phenomenon of blastomere exclusion from compaction: Its relation to irregular cleavage, blastocyst development rate, and pregnancy rate

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Watanabe ◽  
M Tomida ◽  
S Suzuki ◽  
Y Matsuda ◽  
K Yoshikai ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Chromosome Analysis ◽  
Development Rate ◽  
Pregnancy Rates ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Miscarriage Rate ◽  
Single Blastocyst Transfer ◽  
Significant Difference ◽  
Irregular Cleavage

Abstract Study question When does blastomere exclusion from compaction increase and what effect does it have on the embryo? Summary answer More blastomere were excluded from compaction in embryos with irregular cleavage, resulting in lower blastocyst development rates, but no decrease in pregnancy rates at transfer. What is known already It has been reported that many of the chromosome analysis results of blastomere excluded from compaction were aneuploid, and pointed out that this exclusion may be related to the repair of blastocyst euploidy, but the effect of the number of excluded blastomere has not been reported. Study design, size, duration This is a retrospective study of 578 embryos that developed into morula with time-lapse monitoring by EmbryoScope (Vitrolife) in 2018–2019. Participants/materials, setting, methods The target embryos were classified into two groups: embryos with normal first and second cleavage (normal cleavage group) and embryos with irregular cleavage (dynamics of one cell dividing into three or more cells), called “direct cleavage”, at either cleavage (DC group), and the number of blastomere excluded from compaction during morula formation was recorded and compared. The blastocyst development rate and single blastocyst transfer pregnancy rates of the two groups were compared. Main results and the role of chance There are 286 in the normal cleavage group and 292 in the DC group. The mean number of excluded blastomere was 0.76 and 3.55, respectively, which was significantly higher in the DC group (P &lt; 0.01). Good blastocyst (Gardner classification 4 or higher) development rate was 84.5% (239/283) and 65.8% (181/275), respectively, and high grade blastocyst (Gardner classification BB or higher) development rate was 43.9% (105/239) and 14.9% (27/181) of them, both significantly higher in the normal cleavage group (P &lt; 0.01). The single blastocyst transfer pregnancy rates were 31.6% (25/79) and 32.4% (11/34), and the miscarriage rates were 24.0% (6/25) and 27.3% (3/11), respectively, neither was there a significant difference between the two groups. So, direct cleavage increased the number of blastomere excluded from compaction, decreased the rate of morula to good blastocyst development and reduced blastocyst grade, but did not affect blastocyst transfer pregnancy rate and miscarriage rate. Limitations, reasons for caution Please note that all target embryos must have developed into morula or larger (embryos that did not develop into morula will not be included in the study). Wider implications of the findings: Severe chromosomal aberrant blastomeres formed by direct cleavage were excluded from compaction, and the blastocyst development rate decreased due to a decrease in the amount of viable cells, but it is suggested that this blastomere exclusion mechanism is not related to euploidy after blastocyst development. Trial registration number Not applicable

Sexual functioning and sexual well-being in people with a limb amputation: a cross-sectional study in the Netherlands

2015 ◽  
Vol 38 (4) ◽  
pp. 368-373 ◽  
Author(s):  
Jesse E. A. Verschuren ◽  
Jan H. Geertzen ◽  
Paul Enzlin ◽  
Pieter U. Dijkstra ◽  
Rienk Dekker
Keyword(s):  
The Netherlands ◽  
Sexual Functioning ◽  
Well Being ◽  
Cross Sectional Study ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Calving sub-season and reproductive efficiency of beef cows

2010 ◽  
Vol 39 (10) ◽  
pp. 2182-2186
Author(s):  
Cristiane Reinher ◽  
Júlio Otávio Jardim Barcellos ◽  
Vanessa Peripolli ◽  
Ênio Rosa Prates ◽  
Maria Eugênia Andrighetto Canozzi
Keyword(s):  
Pregnancy Rate ◽  
Beef Cows ◽  
Pregnancy Rates ◽  
Reproductive Efficiency ◽  
Climate Variations ◽  
Southern Brazil ◽  
Chi Square ◽  
Chi Square Test

It was evaluated in this work the effect of calving sub-season on the pregnancy rate of 7,726 multiparous Hereford beef cows grazing on natural pastures in southern Brazil, from 1994 to 2007. Calving sub-season periods were divided in 20-day intervals from August 12th to 31st; from September 1st to 20th; from September 21st to October 10th; from October 11th to 31st; from November 1st to 20th. Calving in each sub-season and pregnancy rate (PR) were analyzed by the Chi-square test. Overall means of each sub-season were 92.7% (from August 12th to 31st), 90.6% (from September 1st to 20th), 82.1% (from September 21st to October 10th), 77.7% (from October 11th to 31st), and 70.6% (from November 1st to 20th). Calving sub-season significantly influenced pregnancy rate. Cows which calved in the initial sub-season showed higher pregnancy rates than cows which calved from the fourth calving sub-season. However this difference did not occur in 1999 and in 2007 since calving rates did not statistically differ among the five sub-seasons. In 1998 and 2004, calving rates were lower and the effects of calving sub-season on pregnancy rates were higher, possibly due to climate variations. In general, pregnancy rate decreases as calving occurs later in the year, particularly in years when the weather adversely affects pasture growth.

scholarly journals The Effect of A PRID®Delta-Based Estrus Synchronization Protocol On Pregnancy Rates In Cows With No Estrus Symptoms

2022 ◽  
Author(s):  
Murat Can Demir ◽  
Cihan Kaçar ◽  
Umut Çağın Arı ◽  
Semra Kaya ◽  
Oğuz Merhan ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Artificial Insemination ◽  
Prostaglandin F2α ◽  
Pregnancy Rates ◽  
Dominant Follicle ◽  
Serum Progesterone ◽  
Blood Samples ◽  
Follicle Diameter ◽  
Follicle Size ◽  
Equine Chorionic Gonadotropin

Abstract The present study aimed to determine the effects of progesterone-based gonadotropin-releasing hormone (GnRH), prostaglandin F2α (PGF2α), and equine chorionic gonadotropin (eCG) injections on progesterone profiles and pregnancy rates in cows with no estrus symptoms within 60 days after parturition. A total of 80 cows were included in the study. All animals had the progesterone-releasing device PRID®Delta placed intravaginally for nine days with an injection of GnRH. On the eighth day, PGF2α was injected, and PRID®Delta was removed from the vagina on day nine. Artificial insemination was carried out 60 hours after PRID®Delta removal. In half of the animals (n = 40), 600 IU of eCG was injected when PRID®Delta was removed on the ninth day before artificial insemination 60 hours later. Blood samples were taken from the tail vein on days 0 and 8 to determine progesterone levels. The pregnancy rate in the group that received eCG was 37.5%, while it was 27.5% in those that did not (P = 0.4). While the dominant follicle diameter was 15.5 mm in cows injected with eCG during timed artificial insemination, the follicle diameter was 12.4 mm in cows with no eCG injection (P <0.001). There were no differences in serum progesterone values in blood samples taken until the time of artificial insemination. However, progesterone values in the blood taken during artificial insemination were 0.94 ng/ml in the eCG- group and 0.72 ng/ml in the eCG+ group (P <0.05). As a result, it was determined that eCG injections, in addition to progesterone-based GnRH and PGF2α applications, increased the pregnancy rates in cows without symptoms of estrus. The dominant follicle diameter was larger in cows treated with eCG during artificial insemination; however, follicle size did not increase the pregnancy rate.

Sign in / Sign up

Export Citation Format

Share Document