P-490 Recurrent pregnancy loss acts as a posttraumatic stress event in both women and men

Study question What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies? Summary answer Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner. What is known already About 1-3% of all couples trying to conceive are affected by RPL. The loss of the unborn child can be the most traumatic experience in a woman’s life and is associated with significant psychological distress besides the instant grief. RPL can also be stressful for the partner, even though being at a lower risk for psychiatric morbidities. The man’s gender role expects him to support and not to show weakness which may result in a suppression of his feelings and a disenfranchised grief. Study design, size, duration Cross-sectional study. All women and men referred to the special unit for RPL between March 2019 and October 2020 were asked to participate voluntarily with a total sample size of 105 couples and 17 women. Exclusion criteria were less than two pregnancy losses, inadequate knowledge of the German language and incomplete data. Participants/materials, setting, methods Couples were invited to fill out a questionnaire package estimating their psychological risks (e.g. posttraumatic stress disorder, anxiety, depression, perceived social support) and coping strategies with established instruments. Clinical history was obtained from medical records. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as the unit of analysis. Main results and the role of chance The response rate was 82.3%. The following psychological risks were measured among women versus men: posttraumatic stress disorder (PTSD): 13.7% versus 3.9% (p = 0.017); anxiety: 50.4% versus 17.3% (p < 0.001), depression: 48.1% versus 14.4% (p < 0.001), lack of social support: 32.5% versus 32.7% (N.S.). A risk in at least one category showed 68.9% of women versus 44.8% of men (p < 0.001), with those at higher risk indicating a lower satisfaction with their partnership (p < 0.001) and higher impairment of their sexual life (p < 0.001). Neither total number of pregnancy losses nor time gap since last pregnancy loss showed relevant correlations with psychological risks. For women, number of curettages, controlled for the number of pregnancy losses, correlates with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and a lack of social support in women correlated positively with posttraumatic stress in their partners. The coping strategy “trivialization and wishful thinking” as well as the subscale “avoidance” of the Impact-of-Event-Scale (self-report questionnaire measuring posttraumatic stress) of men was correlated with more severe posttraumatic stress in their female partners (both p < 0.05). Limitations, reasons for caution The data show only correlations between the measured variables, as cross-sectional studies are not suitable to analyse causal relationships. The sample was obtained in a special unit for RPL at a university hospital, so the findings may not be generalizable to all couples with RPL. Wider implications of the findings Screening psychological risks in couples with RPL may be reasonable considering the high risks in both sexes and the extent of PTSD diagnoses in women, their interdependencies and the potential risk of chronification. Professionals should encourage affected couples to support each other and provide targeted information on mental health services. Trial registration number DRKS 00014965

P–490 Recurrent pregnancy loss acts as a posttraumatic stress event in both women and men

Study question What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies? Summary answer Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner. What is known already About 1–3% of all couples trying to conceive are affected by RPL. The loss of the unborn child can be the most traumatic experience in a woman’s life and is associated with significant psychological distress besides the instant grief. RPL can also be stressful for the partner, even though being at a lower risk for psychiatric morbidities. The man’s gender role expects him to support and not to show weakness which may result in a suppression of his feelings and a disenfranchised grief. Study design, size, duration Cross-sectional study. All women and men referred to the special unit for RPL between March 2019 and October 2020 were asked to participate voluntarily with a total sample size of 105 couples and 17 women. Exclusion criteria were less than two pregnancy losses, inadequate knowledge of the German language and incomplete data. Participants/materials, setting, methods Couples were invited to fill out a questionnaire package estimating their psychological risks (e.g. posttraumatic stress disorder, anxiety, depression, perceived social support) and coping strategies with established instruments. Clinical history was obtained from medical records. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as the unit of analysis. Main results and the role of chance The response rate was 82.3%. The following psychological risks were measured among women versus men: posttraumatic stress disorder (PTSD): 13.7% versus 3.9% (p = 0.017); anxiety: 50.4% versus 17.3% (p < 0.001), depression: 48.1% versus 14.4% (p < 0.001), lack of social support: 32.5% versus 32.7% (N.S.). A risk in at least one category showed 68.9% of women versus 44.8% of men (p < 0.001), with those at higher risk indicating a lower satisfaction with their partnership (p < 0.001) and higher impairment of their sexual life (p < 0.001). Neither total number of pregnancy losses nor time gap since last pregnancy loss showed relevant correlations with psychological risks. For women, number of curettages, controlled for the number of pregnancy losses, correlates with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and a lack of social support in women correlated positively with posttraumatic stress in their partners. The coping strategy “trivialization and wishful thinking” as well as the subscale “avoidance” of the Impact-of-Event-Scale (self-report questionnaire measuring posttraumatic stress) of men was correlated with more severe posttraumatic stress in their female partners (both p < 0.05). Limitations, reasons for caution The data show only correlations between the measured variables, as cross-sectional studies are not suitable to analyse causal relationships. The sample was obtained in a special unit for RPL at a university hospital, so the findings may not be generalizable to all couples with RPL. Wider implications of the findings: Screening psychological risks in couples with RPL may be reasonable considering the high risks in both sexes and the extent of PTSD diagnoses in women, their interdependencies and the potential risk of chronification. Professionals should encourage affected couples to support each other and provide targeted information on mental health services. Trial registration number DRKS 00014965

Human-centred design in industry 4.0: case study review and opportunities for future research

The transition to industry 4.0 has impacted factories, but it also affects the entire value chain. In this sense, human-centred factors play a core role in transitioning to sustainable manufacturing processes and consumption. The awareness of human roles in Industry 4.0 is increasing, as evidenced by active work in developing methods, exploring influencing factors, and proving the effectiveness of design oriented to humans. However, numerous studies have been brought into existence but then disconnected from other studies. As a consequence, these studies in industry and research alike are not regularly adopted, and the network of studies is seemingly broad and expands without forming a coherent structure. This study is a unique attempt to bridge the gap through the literature characteristics and lessons learnt derived from a collection of case studies regarding human-centred design (HCD) in the context of Industry 4.0. This objective is achieved by a well-rounded systematic literature review whose special unit of analysis is given to the case studies, delivering contributions in three ways: (1) providing an insight into how the literature has evolved through the cross-disciplinary lens; (2) identifying what research themes associated with design methods are emerging in the field; (3) and setting the research agenda in the context of HCD in Industry 4.0, taking into account the lessons learnt, as uncovered by the in-depth review of case studies.

Childhood, disability and vocational training in Franco's Spain during the 1950s and early 1960s

PurposeThis paper analyses the strategies designed by Franco´s dictatorship to address the “problem” of children with physical disabilities, focusing on the relevance given to vocational training.Design/methodology/approachThe paper draws mainly on official documents, reports from international organisations, and Spanish experts' papers.FindingsFrancoism turned labour into one of the key pillars of its national project and included vocational training in the different stages of school life. From the mid-1950s, vocational training also became a key factor for the dictatorship's strategy towards disability. Following the recommendations issued by international agencies, Francoism began to adopt different measures towards the rehabilitation of children with disabilities. One of them was the creation, in 1959, of a special unit for adolescents within the National Institute for the Rehabilitation of Invalids. In addition to medical treatment, this unit provided children with education and vocational training.Originality/valueThe value of this paper lies in the fact that the topic it analyses has been little studied. Until now no attention has been given to the special unit for adolescents, despite it being a very interesting example of the medical model of disability and its contradictions. During their stay at the unit children were promised greater autonomy and independence, but their lives also became medicalised and they were forced to collaborate with experts.

Importance and utility of Charak Samhita Vimanasthan.

The Charak Samhita is well known Ayurveda classic accredited for its deliberations on basic principles of Ayurveda. It is considered to be a complete text having no short comings. It is also termed as the kalpadruma by the revered commentator Gangadhar Roy. As the legend says, the kalpdruma is a tree that fulfills ones wish and has a plenty to offer. Similarly, the Charak Samhita is a treasure trove of Ayurveda knowledge having unfathomable capacity to deliver the desired. Although, all the eight sections of the text namely sthana are unique in their content, the vimanasthana is a special unit conspicuous by its presence in the Charak Samhita. The other classics like the Sushrut Samhita and Ashtang Hridayam of Vagbhatta lack the vimanasthana. The vimanasthana is the knowledge and measurement unit. It specifies the mode of measurement of doshadi along with the very significant topic of the teaching, research and so on. Therefore, here an attempt has been made to bring the light on significance of vimanasthana.

Best International Practices of Combating Terrorism and Organised Crime by Special Units and Law Enforcement Agencies

Therefore, this unit as a component of the gendarmerie is built on the principle of a military unit. The gendarmerie, one of the few state institutions in France, has been in existence for over 200 years and has a status as DOI: 10.32370/IA_2021_03_07 a significant component of the country's armed forces and is an extremely important part of the police system. The gendarmerie is subordinated to the Ministry of Defense (on the authority of the Main Directorate), and on the ground - to the command of military districts. At the same time, the gendarmerie is at the operational disposal of the Ministry of Internal Affairs and the Ministry of Justice. Significant autonomy within the Armed Forces allows the gendarmerie to combine military functions with purely police and administrative ones. The difference between police and gendarmerie is that the police are civilian civil servants. They can wear civilian clothes and trade union and political freedoms. Gendarmes also have the status of servicemen and military ranks, always in uniform, not entitled to strike and are responsible for violations in accordance with military charters - from guardians to dismissal from service (for example, for the use of alcohol "in the performance of official duties" the gendarme is threatened arrest for up to 30 days). The need for the creation of the Austrian Special Forces was conditioned by the urgency of taking measures to ensure the safety of the flow of emigrants of Jewish nationality from the former USSR since in autumn 1973 against them was committed serious terrorist act. Special unit "Cobra" enters the warehouse of the Ministry of Internal Affairs and has got a double subordination: through direct combat engagement to the head of public safety, and in relation to personnel issues and logistics - the central command of the gendarmerie of the Austrian Ministry of Internal Affairs. Among the well-known British Special Political Service (Special Air Service, or SAS) is probably the best counterterrorism unit. Its component - Special Projects (SP) team - the main anti-terrorist squad. The Special Air Service and its Counter Revolutionary Warfare Squadron (CRW) unit, the Antirevolutionary Military Squadron, were founded in 1942. The feature of training SAS servicemen is to teach each soldier to possess all methods and means of combating terrorism. To achieve this, SAS trains all of its squadron through training cycles. Acquired skills are improved later in the SP-team's combat duties. The main thing in the work is the maximum approximation of training sessions to a real combat situation in the conduct of operations on the release of hostages, in the role of which are civilians. Anti-terrorist training of SAS and the development of practical measures for the release of hostages is facilitated by the fact that high-ranking members of the British Government, including the Prime Minister, are personally involved in it.

NORMALAND ABNORMAL LIQUOR VOLUME AND ITS CORRELATION WITH PERINATAL OUTCOME

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.