Who is the gate keeper for treatment in a fertility clinic in Germany? -baseline results of a prospective cohort study (PinK study).

BACKGROUND: It is estimated that 5-15% of all couples in industrialised nations are infertile. A perceived unfulfilled desire for a child or self-identification as infertile can lead to psychological strain and social isolation. About 53.000 women underwent assisted reproduction treatments in Germany in 2014. Little is known about the first medical consultation and patient needs prior to the first visit in a fertility clinic in Germany. The baseline survey of the prospective cohort study on couples undergoing fertility treatment in Germany (PinK Study) provides first results on this topic for Germany. METHODS: The baseline survey was conducted between 2012 and 2013. Self-administered questionnaires were handed out to patients of six fertility clinics at the beginning of treatment by clinic staff. At a participation rate of 31.0%, we were able to analyse data on 323 women and 242 men. RESULTS: 92.6% of the women had their initial medical consultation on their unfulfilled desire for a child with a gynaecologist. After the urologist (44.2%), the general practitioner (12.0%) was the second most approached initial contact person for men. 36.4% of all men had no medical consultation on the unfulfilled desire for a child before visiting a fertility clinic. 46.9% of the respondents expressed the wish that the conversation about infertility should be initiated by a physician. Prior to their first visit to a fertility clinic, 11.2% of the men and 24.8% of the women were informed by a physician that infertility treatment can cause emotional strain. CONCLUSION: While almost all women consult a gynaecologist prior to the first visit in a fertility centre, one out of three men do not consult any physician at that stage. For the remaining group of men, urologists and general practitioners are the most important contact persons. Gender-specific health care needs are evident. In order to close the health care gap for men in Germany, more opportunities for discreet access to consultation should be offered. Due to its low threshold and family-oriented approach, general practice could make an important contribution to this effect.

The Effects of Urban Living Conditions on Subjective Well-Being: The Case of German Foreign Service Employees.

In an increasingly urbanized world, understanding the determinants of urban well-being will continue to grow in importance. Although the effects of different indicators of living conditions on well-being have been widely studied individually, little is known about their relative impact when examined jointly. In this study, we use a unique multi-source dataset that allows us to investigate the effect and relative importance of a variety of subjectively and objectively assessed aspects of urban living conditions on the subjective well-being (SWB) of German Foreign Service expatriates. The study captures living conditions in metropolises around the world at different stages of development, and assesses living conditions in a culturally comparably homogeneous set of participants, thus being potentially less confounded with cultural differences. Using linear regression and dominance analysis, we find that 'quality of and access to nature' (i.e., green space), 'quality of housing', and 'quality of public goods' (i.e., water, air, and sewage systems) have the strongest associations with SWB. Subjectively rated characteristics show stronger associations with SWB than externally assessed characteristics. Additionally, we examine whether the size of a city or the level of development of a country has an effect on SWB. Both living in a megacity (≥ 10 million inhabitants) and a lower development status have negative effects on SWB. However, these effects disappear when the various indicators of living conditions are controlled for. Our findings can inform organisations sending employees abroad as well as urban planners seeking to improve their policies and decision-making. Supplementary Information: The online version contains supplementary material available at 10.1007/s11482-023-10169-w.

A temporally and spatially explicit, data-driven estimation of airborne ragweed pollen concentrations across Europe.

Ongoing and future climate change driven expansion of aeroallergen-producing plant species comprise a major human health problem across Europe and elsewhere. There is an urgent need to produce accurate, temporally dynamic maps at the continental level, especially in the context of climate uncertainty. This study aimed to restore missing daily ragweed pollen data sets for Europe, to produce phenological maps of ragweed pollen, resulting in the most complete and detailed high-resolution ragweed pollen concentration maps to date. To achieve this, we have developed two statistical procedures, a Gaussian method (GM) and deep learning (DL) for restoring missing daily ragweed pollen data sets, based on the plant's reproductive and growth (phenological, pollen production and frost-related) characteristics. DL model performances were consistently better for estimating seasonal pollen integrals than those of the GM approach. These are the first published modelled maps using altitude correction and flowering phenology to recover missing pollen information. We created a web page (http://euragweedpollen.gmf.u-szeged.hu/), including daily ragweed pollen concentration data sets of the stations examined and their restored daily data, allowing one to upload newly measured or recovered daily data. Generation of these maps provides a means to track pollen impacts in the context of climatic shifts, identify geographical regions with high pollen exposure, determine areas of future vulnerability, apply spatially-explicit mitigation measures and prioritize management interventions.

Health risks of separated or divorced over-indebted fathers: separation from children and financial distress.

The study examines over-indebted fathers after separation/divorce with respect to health-related lifestyles/state of health. A cross-sectional survey was conducted among over-indebted persons in Germany 2006/2007 (response rate 39.7%). Fathers in complete families (n = 73; M = 37 years) and single mothers (n = 72; M = 33.5 years) served as comparison groups to the separated fathers (n = 59; M = 37 years). Risks of depressive mood, unhealthy nutrition, and hypertension were higher compared to fathers in complete families. Tobacco use and low health awareness proved to be higher than among both comparison groups. The findings indicate problematic health-related behavior and health status among separated over-indebted fathers, and suggest recognizing them as a high risk group within social work.

Imaginability of adoption, foster care, and life without a(nother) child and stress in women and men in fertility treatment.

We study whether the imaginability of adoption, foster care, and life without a(nother) child protects from stress during fertility treatment. Data from a self-administered prospective cohort study of couples who had just started treatment were used (T1 = 441 respondents; T2 = 142 respondents). Most respondents cannot imagine alternatives to treatment. Adoption/foster care is preferred over life without children. Imaginability of alternatives is associated with lower fertility-related (T1) and treatment-related stress (T2). Experience of a pregnancy/birth does not moderate the association. Thus, the availability of alternatives to treatment turns out to be helpful in terms of self-regulation during fertility treatment.

Interaction of oculomotor and manual behavior: evidence from simulated driving in an approach-avoidance steering task.

BACKGROUND: While the coordination of oculomotor and manual behavior is essential for driving a car, surprisingly little is known about this interaction, especially in situations requiring a quick steering reaction. In the present study, we analyzed oculomotor gaze and manual steering behavior in approach and avoidance tasks. Three task blocks were implemented within a dynamic simulated driving environment requiring the driver either to steer away from/toward a visual stimulus or to switch between both tasks. RESULTS: Task blocks requiring task switches were associated with higher manual response times and increased error rates. Manual response times did not significantly differ depending on whether drivers had to steer away from vs toward a stimulus, whereas oculomotor response times and gaze pattern variability were increased when drivers had to steer away from a stimulus compared to steering toward a stimulus. CONCLUSION: The increased manual response times and error rates in mixed tasks indicate performance costs associated with cognitive flexibility, while the increased oculomotor response times and gaze pattern variability indicate a parsimonious cross-modal action control strategy (avoiding stimulus fixation prior to steering away from it) for the avoidance scenario. Several discrepancies between these results and typical eye-hand interaction patterns in basic laboratory research suggest that the specific goals and complex perceptual affordances associated with driving a vehicle strongly shape cross-modal control of behavior.

Glassomer-Processing Fused Silica Glass Like a Polymer.

Fused silica glass is one of the most important high-performance materials for scientific research, industry, and society. However due to its high chemical and thermal resistance as well as high hardness, fused silica glass is notoriously difficult to structure. This work introduces Glassomer, a solid nanocomposite, which can be structured using polymer molding and subtractive technologies at submicrometer resolution. After polymer processing Glassomer is turned into optical grade fused silica glass during a final heat treatment. The resulting glass has the same optical transparency as commercial fused silica and a smooth surface with a roughness of a few nanometers. This work makes high-performance fused silica glass components accessible to high-throughput fabrication technologies and will enable numerous optical, photonic and medical applications in science and industry.

Liquid Glass: A Facile Soft Replication Method for Structuring Glass.

Liquid glass is a photocurable amorphous silica nanocomposite that can be structured using soft replication molds and turned into glass via thermal debinding and sintering. Simple polymer bonding techniques allow the fabrication of complex microsystems in glass like microfluidic chips. Liquid glass is a step toward prototyping of glass microstructures at low cost without requiring cleanroom facilities or hazardous chemicals.

Car Gestures - Advisory warning using additional steering wheel angles.

Advisory warning systems (AWS) notify the driver about upcoming hazards. This is in contrast to the majority of currently deployed advanced driver assistance systems (ADAS) that manage emergency situations. The target of this study is to investigate the effectiveness, acceptance, and controllability of a specific kind of AWS that uses the haptic information channel for warning the driver. This could be beneficial, as alternatives for using the visual modality can help to reduce the risk of visual overload. The driving simulator study (N=24) compared an AWS based on additional steering wheel angle control (Car Gestures) with a visual warning presented in a simulated head-up display (HUD). Both types of warning were activated 3.5s before the hazard object was reached. An additional condition of unassisted driving completed the experimental design. The subjects encountered potential hazards in a variety of urban situations (e.g. a pedestrian standing on the curbs). For the investigated situations, subjective ratings show that a majority of drivers prefer visual warnings over haptic information via gestures. An analysis of driving behavior indicates that both warning approaches guide the vehicle away from the potential hazard. Whereas gestures lead to a faster lateral driving reaction (compared to HUD warnings), the visual warnings result in a greater safety benefit (measured by the minimum distance to the hazard object). A controllability study with gestures in the wrong direction (i.e. leading toward the hazard object) shows that drivers are able to cope with wrong haptic warnings and safety is not reduced compared to unassisted driving as well as compared to (correct) haptic gestures and visual warnings.