scholarly journals Time to first birth and its determinants among married female youths in Ethiopia, 2020: survival analysis based on EDHS 2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Desalegn Anmut Bitew ◽  
Yohannes Ayanaw Habitu ◽  
Abebaw Addis Gelagay
Keyword(s):  
Survival Analysis ◽  
Personal Development ◽  
Multivariable Analysis ◽  
Unmet Need ◽  
Categorical Variables ◽  
Age At First Birth ◽  
Proportional Hazard ◽  
First Birth ◽  
First Sex ◽  
Married Female

Abstract Introduction The first birth is the most significant events in a woman's life that indicates the beginning of undertaking the intensive responsibilities of motherhood and childcare. Age at first birth has health, economic and social consequences and implications. But little has been known on the time to first birth and its determinants in Ethiopia. Therefore, this research is planned to address this issue. Objectives of the study To assess the time to first birth and its determinants among married female youths in Ethiopia, 2020. Methods The data was accessed freely through (https://www.dhsprogram.com). Survival analysis of time to first birth was done based on EDHS 2016 data among 2597 weighted study subjects. The data was extracted using STATA version 14.0. Kaplan Meier’s survival and Log rank test were used to compare survival experiences of respondents using categorical variables. Proportional hazard assumption was checked and was not violated. Cox proportional hazard model was applied, hazard ratio with 95% CI was computed and variables with p value < 0.05 in the multivariable analysis were taken as significant determinants. Results Overall median survival time was 18 years (IQR = 17–20). The significant determinants of time to first birth are place of residence (being rural (AHR = 1.49, 95% CI 1.13, 1.97),Religion (being Muslim [AHR = 1.57, 95% CI 1.22, 2.02),being protestant (AHR = 1.73, 95% CI 1.34, 2.24)], age at first sex [first sex < 15 years (AHR = 1.68, 95% CI 1.23, 2.29)] and first sex between 15 and 17 years (AHR = 1.54, 95% CI 1.29, 1.85), age at first marriage (marriage < 15 years (AHR = 6.52, 95% CI 4.91, 8.64), marriage between 15 and 17 (AHR = 2.63, 95% CI 2.20, 3.14), unmet need for family planning (AHR = 1.23, 95% CI 1.00, 1.52) Conclusion In this study, the median age at first birth was 18 years. This show, about 50% of study participants give birth for the first time before their 18th birth day. This age is the ideal age for schooling and to do other personal development activities. Therefore giving birth before 18 year will limit female youths from attending school and performing personal development activities in addition to health and demographic consequences of early child bearing.

Relationship of hospital volume on outcomes in patients with acute pulmonary embolism: Analysis of a 70,000 patient database

2020 ◽  
pp. 1358863X2097026
Author(s):  
Mark Finkelstein ◽  
Mario A Cedillo ◽  
David C Kestenbaum ◽  
Obaib S Shoaib ◽  
Aaron M Fischman ◽  
...  
Keyword(s):  
New York ◽  
Pulmonary Embolism ◽  
Length Of Stay ◽  
New York State ◽  
Multivariable Analysis ◽  
High Volume ◽  
Categorical Variables ◽  
Patient Database ◽  
Very High ◽  
Total Charges

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges.

Railway Passengers Travel Time Research Based on Survival Analysis

2014 ◽  
Vol 962-965 ◽  
pp. 2580-2583
Author(s):  
Ya Chen Zhao ◽  
Zhen Yu Zhang ◽  
Qing Jie Zheng
Keyword(s):  
Survival Analysis ◽  
Travel Time ◽  
Significant Influence ◽  
Hazard Rate ◽  
Family Income ◽  
Proportional Hazard ◽  
Rate Model ◽  
Analysis Method ◽  
Cox Proportional Hazard ◽  
Hazard Rate Model

With the development of the economy, people have higher request for the time. Studying the choice of travel about rail passengers becomes more significant. Due to these problem above and using survival analysis method, this paper builds travel time survival model based on questionnaire and have a whole analysis of the travel time of the rail passenger. Then, it concludes that most of the rail passengers’ travel time is below five hours. At last, this paper builds COX proportional hazard rate model of travel time and study the factors about travel time. The result demonstrates that the factor about whether it is students or not, family income, whether it is travelling and the number of packages has a significant influence on the travel time.

scholarly journals Variations in reproductive events across life: a pooled analysis of data from 505 147 women across 10 countries

2019 ◽  
Vol 34 (5) ◽  
pp. 881-893 ◽  
Author(s):  
Keyword(s):  
Age At Menarche ◽  
Age At First Birth ◽  
First Birth ◽  
Natural Menopause ◽  
Individual Level ◽  
Level Data ◽  
Education Levels ◽  
Reproductive Events ◽  
Racial Ethnic ◽  
Reproductive Indices

Abstract STUDY QUESTION How has the timing of women’s reproductive events (including ages at menarche, first birth, and natural menopause, and the number of children) changed across birth years, racial/ethnic groups and educational levels? SUMMARY ANSWER Women who were born in recent generations (1970–84 vs before 1930) or those who with higher education levels had menarche a year earlier, experienced a higher prevalence of nulliparity and had their first child at a later age. WHAT IS KNOWN ALREADY The timing of key reproductive events, such as menarche and menopause, is not only indicative of current health status but is linked to the risk of adverse hormone-related health outcomes in later life. Variations of reproductive indices across different birth years, race/ethnicity and socioeconomic positions have not been described comprehensively. STUDY DESIGN, SIZE, DURATION Individual-level data from 23 observational studies that contributed to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) consortium were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Altogether 505 147 women were included. Overall estimates for reproductive indices were obtained using a two-stage process: individual-level data from each study were analysed separately using generalised linear models. These estimates were then combined using random-effects meta-analyses. MAIN RESULTS AND THE ROLE OF CHANCE Mean ages were 12.9 years at menarche, 25.7 years at first birth, and 50.5 years at natural menopause, with significant between-study heterogeneity (I2 &gt; 99%). A linear trend was observed across birth year for mean age at menarche, with women born from 1970 to 1984 having menarche one year earlier (12.6 years) than women born before 1930 (13.5 years) (P for trend = 0.0014). The prevalence of nulliparity rose progressively from 14% of women born from 1940–49 to 22% of women born 1970–84 (P = 0.003); similarly, the mean age at first birth rose from 24.8 to 27.3 years (P = 0.0016). Women with higher education levels had fewer children, later first birth, and later menopause than women with lower education levels. After adjusting for birth year and education level, substantial variation was present for all reproductive events across racial/ethnic/regional groups (all P values &lt; 0.005). LIMITATIONS, REASONS FOR CAUTION Variations of study design, data collection methods, and sample selection across studies, as well as retrospectively reported age at menarche, age at first birth may cause some bias. WIDER IMPLICATIONS OF THE FINDINGS This global consortium study found robust evidence on variations in reproductive indices for women born in the 20th century that appear to have both biological and social origins. STUDY FUNDING/COMPETING INTEREST(S) InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). GDM is supported by the Australian National Health and Medical Research Council Principal Research Fellowship (APP1121844).

scholarly journals Psychosocial Telephone Counseling for Survivors of Cervical Cancer: Results of a Randomized Biobehavioral Trial

2015 ◽  
Vol 33 (10) ◽  
pp. 1171-1179 ◽  
Author(s):  
Lari Wenzel ◽  
Kathryn Osann ◽  
Susie Hsieh ◽  
Jo A. Tucker ◽  
Bradley J. Monk ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Telephone Counseling ◽  
Longitudinal Change ◽  
Categorical Variables ◽  
Patient Reported ◽  
Cytokine Levels ◽  
Cancer Experience

Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.

Antebellum Southern White Fertility: A Demographic and Economic Analysis

1980 ◽  
Vol 40 (2) ◽  
pp. 331-350 ◽  
Author(s):  
Richard H. Steckel
Keyword(s):  
Economic Analysis ◽  
Total Fertility Rate ◽  
Time Trend ◽  
Age At First Birth ◽  
Demographic Analysis ◽  
First Birth ◽  
Distribution Of Wealth ◽  
Socioeconomic Analysis ◽  
Family Limitation ◽  
Child Spacing

This paper investigates the decline and regional differential in antebellum southern white fertility using published census materials and the 1860 population schedules. Demographic analysis is conducted with a synthetic total fertility rate that has four components: age at first birth, age at last surviving birth, surviving-child spacing, and the proportion of women who eventually have surviving children. The socioeconomic analysis employs regressions and focuses on causes of the underlying changes in the components. Family limitation appears to have been unimportant in this population. The distribution of wealth was.probably an important factor shaping the time trend and regional differential in fertility.

Pregnancy and the Risk of Rheumatoid Arthritis in a Highly Predisposed North American Native Population

2012 ◽  
Vol 39 (12) ◽  
pp. 2253-2260 ◽  
Author(s):  
CHRISTINE A. PESCHKEN ◽  
DAVID B. ROBINSON ◽  
CAROL A. HITCHON ◽  
IRENE SMOLIK ◽  
DONNA HART ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
North American ◽  
Shared Epitope ◽  
Reproductive History ◽  
Early Age ◽  
Age At First Birth ◽  
Native Population ◽  
First Birth ◽  
Pregnancy Smoking ◽  
First Time

Objective.To examine reproductive history and rheumatoid arthritis (RA) risk in a highly predisposed population of North American Natives (NAN) with unique fertility characteristics.Methods.The effect of pregnancy on the risk of RA was examined by comparing women enrolled in 2 studies: a study of RA in NAN patients and their unaffected relatives; and NAN patients with RA and unrelated healthy NAN controls enrolled in a study of autoimmunity. All participants completed questionnaires detailing their reproductive history.Results.Patients with RA (n = 168) and controls (n = 400) were similar overall in age, education, shared epitope frequency, number of pregnancies, age at first pregnancy, smoking, and breastfeeding history. In multivariate analysis, for women who had ≥ 6 births the OR for developing RA was 0.43 (95% CI 0.21–0.87) compared with women who had 1–2 births (p = 0.046); for women who gave birth for the first time after age 20 the OR for developing RA was 0.33 (95% CI 0.16–0.66) compared with women whose first birth occurred at age ≤ 17 (p = 0.001). The highest risk of developing RA was in the first postpartum year (OR 3.8; 95% CI 1.45–9.93) compared with subsequent years (p = 0.004).Conclusion.In this unique population, greater parity significantly reduced the odds of RA; an early age at first birth increased the odds, and the postpartum period was confirmed as high risk for RA onset. The protective effect of repeated exposure to the ameliorating hormonal and immunological changes of pregnancy may counterbalance the effect of early exposure to the postpartum reversal of these changes.

Early Bone Metastases are Associated with Worse Outcomes in Metastatic Urothelial Carcinoma

2021 ◽  
pp. 1-10
Author(s):  
Ariel A. Nelson ◽  
Robert J. Cronk ◽  
Emily A. Lemke ◽  
Aniko Szabo ◽  
Ali R. Khaki ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Urothelial Carcinoma ◽  
Clinical Outcomes ◽  
De Novo ◽  
Opioid Analgesic ◽  
Multivariable Analysis ◽  
Unmet Need ◽  
Risk Of Death ◽  
Platinum Based Chemotherapy ◽  
Metastatic Urothelial Carcinoma

BACKGROUND: Outcomes of patients with metastatic urothelial carcinoma (mUC) with early bone metastases (eBM) vs no early bone metastases (nBM) have not thoroughly been described in the age of immuno-oncology. OBJECTIVE: To compare survival and other clinical outcomes in patients with eBM and nBM. METHODS: We used a multi-institutional database of patients with mUC treated with systemic therapy. Demographic, metastatic site, treatment patterns, and clinical outcomes were recorded. Wilcoxon rank-sum, chi-square tests were performed. Survival was estimated by Kaplan-Meier method; multivariable Cox analysis was performed. RESULTS: We identified 270 pts, 67%men, mean age 69±11 years. At metastatic diagnosis, 27%had≥1 eBM and were more likely to have de novo vs. recurrent metastases (42%vs 19%, p <  0.001). Patients with eBM had shorter overall survival (OS) vs. those with nBM, (6.1 vs 13.7 months, p <  0.0001). On multivariable analysis, eBM independently associated with higher risk of death, HR = 2.52 (95%CI: 1.75–3.63, p <  0.0001). OS was shorter for patients with eBM who received initial immune checkpoint inhibitor vs platinum-based chemotherapy, (1.6 vs 9.1 months, p = 0.02). Patients with eBM received higher opioid analgesic doses compared to patients with nBM and received quantitatively more palliative radiation. CONCLUSIONS: Patients with mUC and eBM have poorer outcomes, may benefit less from anti-PD-1/PD-L1 therapy and represent an unmet need for novel therapeutic interventions. Dedicated clinical trials, biomarker validation to assist in patient selection, as well as consensus on reporting of non-measurable disease are required.

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