scholarly journals The journey from infertility to uterus transplantation: A mixed-methods study of the perspectives of participants in the Dallas Uterus Transplant Study (DUETS)

Author(s):  
Anji Wall ◽  
Liza Johannesson ◽  
Monica Sok ◽  
Ann Marie Warren ◽  
Elisa Gordon ◽  
...  

Objective: To study the impact of absolute uterine factor infertility (AUFI) and uterus transplantation (UTx) on women, and UTx recipients’ perceptions of Utx and reproductive autonomy Design: Convergent mixed-methods study. Setting: UTx program in a large academic medical centre in the United States. Population/Sample: 20 Utx recipients Methods: A medical chart review was conducted to collect patient demographic information, and clinical outcomes. Semi-structured interviews collected information regarding participants’ experience. Main Outcome Measure(s): The outcomes of interest were participants’ experience of infertility, experience with UTx, and general perceptions of UTx. Results: 7 participants were pregnant (one with a second child), 6 had experienced early graft failure and removal, 5 had delivered a healthy baby, and 4 had a viable graft and were awaiting embryo transfer. The primary themes identified were: the negative impact of AUFI diagnosis on psychological wellbeing, relationships, and female identity; the positive impact of UTx on healing the emotional scars of AUFI, female identity, and value of research trial participation; and the perception of UTx as an expansion of reproductive autonomy. All participants reported Utx was worthwhile, regardless of individual outcome. On bivariate analysis, disease aetiology, having a child after uterus transplantation, experiencing graft failure and current pregnancy were not significantly associated with the impact of AUFI or of UTx on participants’ identities. Conclusion: AUFI has a negative impact on women from a young age, affects multiple relationships, and challenges female identity. UTx helps reverse this impact, transforming women’s life narrative of infertility and enhancing female identity.

2021 ◽  
Author(s):  
Rebecca Bundy ◽  
William Mandy ◽  
Laura Crane ◽  
Hannah Belcher ◽  
Laura Bourne ◽  
...  

The COVID-19 pandemic has been associated with mental health declines in the general population. Those with pre-existing vulnerabilities are known to be at particular risk. This may include autistic people, who have high levels of mental and physical health problems. Yet little is currently known about the impact of the pandemic on autistic people. Using an online survey, this mixed-methods study gathered data from 133 autistic adults in the United Kingdom (UK), about their experiences of the pandemic in relation to their mental health. Results indicated that the mental health impact of the pandemic on autistic adults was variable. A sizeable minority reported improvements in their mental health associated with COVID-19 restrictions. By contrast, most participants described an overall negative impact their levels of depression, anxiety and stress. Analysis of qualitative data using thematic analysis highlighted four themes that contributed to mental health changes in autistic adults: (i) adjusting to changes to the social world, (ii) living with uncertainty, (iii) disruptions to self-regulation, and (iv) barriers to fulfilling basic needs. Based on these findings, we discuss recommendations about how to support autistic people; both as the pandemic persists and once normality ensues.


2021 ◽  
pp. 197140092098866
Author(s):  
Daniel Thomas Ginat ◽  
James Kenniff

Background The COVID-19 pandemic led to a widespread socioeconomic shutdown, including medical facilities in many parts of the world. The purpose of this study was to assess the impact on neuroimaging utilisation at an academic medical centre in the United States caused by this shutdown. Methods Exam volumes from 1 February 2020 to 11 August 2020 were calculated based on patient location, including outpatient, inpatient and emergency, as well as modality type, including computed tomography and magnetic resonance imaging. 13 March 2020 was designated as the beginning of the shutdown period for the radiology department and 1 May 2020 was designated as the reopening date. The scan volumes during the pre-shutdown, shutdown and post-shutdown periods were compared using t-tests. Results Overall, neuroimaging scan volumes declined significantly by 41% during the shutdown period and returned to 98% of the pre-shutdown period levels after the shutdown, with an estimated 3231 missed scans. Outpatient scan volumes were more greatly affected than inpatient scan volumes, while emergency scan volumes declined the least during the shutdown. In addition, the magnetic resonance imaging scan volumes declined to a greater degree than the computed tomography scan volumes during the shutdown. Conclusion The shutdown from the COVID-19 pandemic had a substantial but transient impact on neuroimaging utilisation overall, with variable magnitude depending on patient location and modality type.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shahram Zaheer ◽  
Liane Ginsburg ◽  
Hannah J. Wong ◽  
Kelly Thomson ◽  
Lorna Bain ◽  
...  

Abstract Background This study contributes to a small but growing body of literature on how context influences perceptions of patient safety in healthcare settings. We examine the impact of senior leadership support for safety, supervisory leadership support for safety, teamwork, and turnover intention on overall patient safety grade. Interaction effects of predictors on perceptions of patient safety are also examined. Methods In this mixed methods study, cross-sectional survey data (N = 185) were collected from nurses and non-physician healthcare professionals. Semi-structured interview data (N = 15) were collected from nurses. The study participants worked in intensive care, general medicine, mental health, or the emergency department of a large community hospital in Southern Ontario. Results Hierarchical regression analyses showed that staff perceptions of senior leadership (p < 0.001), teamwork (p < 0.01), and turnover intention (p < 0.01) were significantly associated with overall patient safety grade. The interactive effect of teamwork and turnover intention on overall patient safety grade was also found to be significant (p < 0.05). The qualitative findings corroborated the survey results but also helped expand the characteristics of the study’s key concepts (e.g., teamwork within and across professional boundaries) and why certain statistical relationships were found to be non-significant (e.g., nurse interviewees perceived the safety specific responsibilities of frontline supervisors much more broadly compared to the narrower conceptualization of the construct in the survey). Conclusions The results of the current study suggest that senior leadership, teamwork, and turnover intention significantly impact nursing staff perceptions of patient safety. Leadership is a modifiable contextual factor and resources should be dedicated to strengthen relational competencies of healthcare leaders. Healthcare organizations must also proactively foster inter and intra-professional collaboration by providing teamwork educational workshops or other on-site learning opportunities (e.g., simulation training). Healthcare organizations would benefit by considering the interactive effect of contextual factors as another lever for patient safety improvement, e.g., lowering staff turnover intentions would maximize the positive impact of teamwork improvement initiatives on patient safety.


2021 ◽  
Vol 2021 (23) ◽  
pp. 237-250
Author(s):  
Anatolii Morozov ◽  
◽  
Tetiana Morozova ◽  
Inessa Rutkovska ◽  
◽  
...  

Introduction.The main environmental risks posed by roads are population depletion (deaths on roads) and barrier effects (habitat fragmentation). Barrier effects - animals avoid crossing roads, which leads to a decrease in the size and quality of habitat, optimal population size, reduced ability to find food and partner, increased genetic structuring and local extinction (Forman et al. 2003; Andrews et al. 2015; van der Ree et al. 2015). These risks against the background of other stressors, in particular the presence of invasive species, pollution, pesticide use, climate change, plant and animal diseases, may threaten the survival of populations.This issue is especially relevant for herpetofauna due to their biological characteristics. In particular, reptiles and amphibians move slowly, are too small (for drivers to see), do not avoid roads, and in cold periods roads attract amphibians (thermoregulation) because the coating absorbs and retains heat (Case and Fisher 2001; Jochimsen et al. 2004).The principle of ensuring ecological continuity is to identify priority efforts to mitigate environmental risks for animals and reduce the negative impact of the transport complex as a spatial barrier and source of pollution by introducing a number of technical means (eco-crossings, screens, embankments, landscaping). As it is not possible to change the environmental risks on all roads and for all species at present, it is necessary to identify the most vulnerable species, assess the risks to populations and the need for mitigation based on analysis of road density and traffic intensity.Problem Statement. With the advent of land transport there was a progressive environmental problem - the transformation of landscapes, it first appeared in countries with developed road infrastructure in Western Europe and the United States, and quickly spread around the globe (Ellenberg, et al., 1981; Fetisov, 1999; Zagorodnyuk, 2006, Ilyukh, Khokhlov, 2012). Numerous publications by both foreign and domestic authors are devoted to the study of the impact of transport infrastructure. Special attention of European authors is paid to the study of the phenomenon of fragmentation of natural ecosystems. In Europe, there is a network of experts and institutions of IENE, which is studying the possibility of implementing preventive measures for landscape fragmentation, promotes the development of transport infrastructure in accordance with environmental requirements, by creating a safe, environmentally sustainable European transport infrastructure.The ecological trail of the road network significantly exceeds its length (Vozniuk, 2014). This is due to the effects of, in particular, mortality on the roads of mammals, reptiles, reptiles (Forman et al. 2003), landscape fragmentation (roads divide the area into isolated areas, with low populations (sometimes below the minimum), so such populations lose genetic diversity and may become extinct locally), the loss of habitats of species and a decrease in the level of connectivity. In addition to these obvious effects, noise and vibration pollution are added, which inhibit the ability of reptiles, birds and mammals to detect prey or avoid predators (Forman et al. 2003), disturbed light regime (Rich and Longcore 2006). Roads contribute to the development of soil erosion processes, the spread of invasive and introduced species (300-800 seeds/m2 per year are transported to roadside ecotones by vehicles (Von der Lippe and Kowarik 2007), which contributes to the formation of local pseudo-populations), create obstacles and sources. (Forman et al. 2003).Purpose. Substantiation of the principle of ecological continuity regarding the negative impact of transport infrastructure on natural ecosystems and search for possible ways to minimize and prevent such impact.Materials and methods. The main research methods are the application of theoretical general scientific approaches to study: analysis and synthesis of international and domestic scientific and theoretical works, EU documentation (charters, design requirements), Ukrainian legal framework, literature sources; collection and analysis of statistical data to identify the dangers of the impact of road infrastructure on biodiversity and determine the value of the natural landscape.Results. The result is an analysis of the scientific literature on the negative impact of transport infrastructure on animals, systematization of the main impacts for the preparation of methodological documents for organizations planning and designing transport infrastructure in Ukraine to reduce the negative impact.Conclusions. The principle of ensuring ecological continuity is to minimize the negative consequences for the environment. In particular, by leveling the spatial barrier of the public highway. When laying a road through natural ecosystems, it is necessary to build transitions and passages for animals. In this case, their density and type must correspond to the natural rank of the territory. The construction of crossings for animals should be mandatory for all types of roads that cross ecological corridors. This is especially true for smaller roads, completely devoid of any transitions for animals, noise shields (on such roads are more likely to hit animals). An important point is the need to plan preventive methods at the planning stage of road construction. The analysis of the European experience shows that the negative impact of transport infrastructure on biota can be solved by consolidating the efforts of road transport specialists and specialists in the field of nature protection.Keywords:motor road,wildlife crossing, biodiversity, road infrastructure, ecological continuity


2018 ◽  
Vol 24 (2) ◽  
pp. 231-254
Author(s):  
Soma Patra

Nine out of the last ten recessions in the United States have been preceded by an increase in the price of oil as noted by Hamilton [Palgrave Dictionary of Economics]. Given the small share of energy in gross domestic product this phenomenon is difficult to explain using standard models. In this paper, I show that firm entry can be an important transmission and amplifying channel for energy price shocks. The results from the baseline dynamic stochastic general equilibrium (DSGE) model predict a drop in output that is two times the impact in a model without entry. The model also predicts an increase in energy prices would lead to a decline in real wages, investment, consumption, and return on investment. Additionally, using US firm level data, I demonstrate that a rise in energy prices has a negative impact on firm entry as predicted by the DSGE model. This lends further support toward endogenizing firm entry when analyzing the effects of energy price shocks.


2021 ◽  
Vol 4 (Special2) ◽  
pp. 402-414
Author(s):  
Samuel Grimwood ◽  
Kaz Stuart ◽  
Ruth Browning ◽  
Elaine Bidmead ◽  
Thea Winn-Reed

Background: The COVID-19 pandemic has profoundly impacted the health of individuals physically, mentally, and socially. This study aims to gain a deeper understanding of this impact across the pandemic from a biopsychosocial stance. Methods: A survey created by the research team was employed between November 2020 and February 2021 across social media, relevant organizations, and networks. The survey incorporated 5-time points across the different stages of the pandemic, covering biological, psychological, and social. There were 5 items for each survey (Very Positive affect to Very Negative affect), and analysis was undertaken using SPSS version 16. Descriptive statistics and non-parametric Friedman and Wilcoxon Tests, as well as correlations between the three domains, were implemented. Results: This study included 164 participants (77.0% female and 35.0% male) across 24 out of 38 counties in the UK. The impact of COVID-19 on biological domain was significant across the five data points χ2(4) = 63.99, p < 0.001, psychological χ2(4) = 118.939, p <0.001 and socially χ2(4) = 186.43, p <0.001. Between the 5 data points, 4 out of 5 had a negative impact, however between the first stage of lockdown and the easing of restrictions, findings for biological (Z=-2.35, p <0.05), psychological (Z=-6.61, p < 0.001), and socially (Z = -8.61, p <0.001) were positive. Negative correlations between the three domains across the pandemic are apparent, but in later stages, the biological domain had a positive correlation r = 0.52, p < 0.001. Conclusion: The data shows a negative impact from the self-reported perception of wellbeing from a biopsychosocial stance over time, as well as perceiving the three domains to interact negatively. To address these biopsychosocial issues, the research implies a place-based integrated recovery effort is needed, addressing biological, psychological, and social issues simultaneously. Further research should investigate biopsychosocial health among a more generalizable population.


Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2349
Author(s):  
Heather Clements ◽  
Stephanie Valentin ◽  
Nicholas Jenkins ◽  
Jean Rankin ◽  
Nancy R. Gee ◽  
...  

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories.


Author(s):  
Kelley Erin Carpenter Massengale ◽  
Cherese Childers-McKee ◽  
Aerin Benavides

Abstract: Applying transformational critical advocacy research in college instruction can be a powerful way to engage students in challenging inequity in society and promoting positive changes. Few studies systematically measure the impact of such pedagogy on the development of college students’ beliefs about advocacy. In this mixed methods study, we worked with 21 preservice teachers through advocacy letter writing activities and collected data from pre/post surveys and focus group discussions to explore the impact of such pedagogy. The findings indicated that advocacy letter writing was a meaningful activity for preservice teachers, allowing them a professional opportunity to voice their concerns about personally meaningful issues to entities in power. A significant correlation was found between baseline advocacy experiences and baseline advocacy beliefs, suggesting that the teaching of advocacy, when combined with opportunities for meaningful practice, can contribute to shifts in belief about the importance of advocating. 


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