Reproductive Efficiency as a Social Indicator

1976 ◽  
Vol 6 (3) ◽  
pp. 455-473 ◽  
Author(s):  
Charlotte Muller ◽  
Frederick S. Jaffe ◽  
Mary Grace Kovar
Keyword(s):  
Teenage Pregnancy ◽  
Social Indicator ◽  
Adverse Outcomes ◽  
Reproductive Efficiency ◽  
Reproductive Process ◽  
Medical Care Costs ◽  
Economic Weights ◽  
Unwanted Pregnancies ◽  
Pregnancy Wastage ◽  
And Control

An index of reproductive efficiency (RE) is proposed as a social indicator that will meet the need to consider various forms of pregnancy wastage, to compare their relative costs, and to guide reproductive health policy accordingly. This article discusses conceptual and measurement aspects of RE. Conversion of wanted to unwanted pregnancies and the reverse, interpretation of abortion in relation to other pregnancy outcomes, defining the end point for the reproductive process and criteria for the events to be included as significant outcomes are conceptual issues. Measurement problems include: whether aggregation is justified, prospective and retrospective tracking of outcomes, record limitations, duplication of adversities in a single pregnancy, and selection of optimal rates for comparison. A measurement of RE for the entire United States based on the National Natality Survey of 1964–1966 is presented, showing 74.5 percent of pregnancies resulting in healthy liveborn infants. For those years, data on abortions could not be included. Within the group of reported pregnancy losses, the importance of congenital abnormalities and low-birth-weight babies is enhanced by application of economic weights based on associated medical care costs. Changing opportunities for birth timing, prenatal and infant care, and control of family size are social means of reducing adverse outcomes associated with teenage pregnancy and high-parity births, often found together with poverty. Successive increments in RE may be progressively more expensive to achieve, and cost effectiveness comparisons will be necessary.

scholarly journals Effects of a new thyrotropic drug isolated from Potentilla alba on the male reproductive system of rats and offspring development

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lubov V. Krepkova ◽  
Valentina V. Bortnikova ◽  
Aleksandra N. Babenko ◽  
Praskovya G. Mizina ◽  
Vladimir A. Mkhitarov ◽  
...  
Keyword(s):  
Animal Study ◽  
Male Fertility ◽  
Wistar Rats ◽  
Medical Condition ◽  
Adverse Outcomes ◽  
Female Rats ◽  
Childbearing Age ◽  
Offspring Development ◽  
Male Wistar Rats ◽  
And Control

Abstract Background The dysfunction of the thyroid gland is a common medical condition. Nowadays, patients frequently use medicinal herbs as complementary or alternative options to conventional drug treatments. These patients may benefit from treatment of thyroid dysfunctions with Potentilla alba L. preparations. While it has been reported that Potentilla alba preparations have low toxicity, nothing is known about their ability to affect reproductive functions in patients of childbearing age. Methods Male Wistar rats were orally treated with a thyrotrophic botanical drug, standardized Potentilla alba Dry Extract (PADE), at doses 8 and 40 times higher than the median therapeutic dose recommended for the clinical trials, for 60 consecutive days. Male Wistar rats receiving water (H2O) were used as controls. After completing treatment, half of the PADE-treated and control males were used to determine PADE gonadotoxicity, and the remaining half of PADE-treated and control males were mated with intact females. Two female rats were housed with one male for two estrus cycles. PADE effects on fertility and fetal/offspring development were evaluated. Results Herein, we report that oral treatment of male Wistar rats with PADE before mating with intact females instigated marked effects on male reproductive organs. Treatment significantly decreased the motility of the sperm and increased the number of pathological forms of spermatozoa. Additionally, a dose-dependent effect on Leydig cells was observed. However, these PADE effects did not significantly affect male fertility nor fetal and offspring development when PADE-treated males were mated with intact females. Conclusions PADE treatment of male rates negatively affected sperm and testicular Leydig cell morphology. However, these changes did not affect male fertility and offspring development. It is currently not known whether PADE treatment may affect human male fertility and offspring development. Therefore, these results from an animal study need to be confirmed in humans. Results from this animal study can be used to model the exposure-response relationship and adverse outcomes in humans.

scholarly journals Factors Influencing HIV/AIDS and Risky Sexual Behaviour Among Learners in South Africa

2018 ◽  
Vol 10 (5) ◽  
pp. 197 ◽  
Author(s):  
Pelonomi F. Malga ◽  
Boitumelo Marilyn Setlalentoa ◽  
Choja Oduaran ◽  
Nopasika Maforah
Keyword(s):  
Attitude Change ◽  
Sexual Behaviour ◽  
Teenage Pregnancy ◽  
Risky Sexual Behaviour ◽  
Health Concern ◽  
Mixed Method Research ◽  
Key Factor ◽  
Unwanted Pregnancies ◽  
Training Programmes ◽  
Hiv Aids

HIV/AIDS is a global health concern and young people are more at risk of being infected. The explored factors that contribute to HIV/AIDS and risky sexual behaviour among learners aged 12-18 years in Vuyolwethu High School. The study focused on learners who were in Grade 10-12. This study employed a mixed method research. Quantitative phase was limited to learners while the qualitative phase focused on life-orientation teachers. The total study sample is 150, and the gender distribution is equally distributed at 50% for both males and females. The dominating age and grade among respondents is age 17-18 years and grade 11. Quantitative data were subjected to descriptive analyses while thematic analysis is employed for analysis of qualitative data. Overall, about 51.3% of the respondents strongly agreed that engaging in sexual intercourse without protection is risky, and that unprotected sexual activity can lead to unwanted sexual encounters, unwanted teenage pregnancy and HIV/AIDS. Similarly, substance abuse is found to be a key factor that influences risky sexual behaviour among adolescents, thus resulting to unwanted pregnancies and HIV/AIDS infection. The main conclusion drawn from the findings is that while adolescents seem to be knowledgeable on the factors that contribute to risky sexual behaviour, this knowledge does not lead to attitude change. It is therefore recommended, based on the study’s findings, that there should be more focused training programmes directed not only at knowledge but also attitude and behaviour change.

The importance of timing: The varying impact of childhood and adolescent maltreatment on multiple problem outcomes

2001 ◽  
Vol 13 (4) ◽  
pp. 957-979 ◽  
Author(s):  
TERENCE P. THORNBERRY ◽  
TIMOTHY O. IRELAND ◽  
CAROLYN A. SMITH
Keyword(s):  
Drug Use ◽  
Youth Development ◽  
Teen Pregnancy ◽  
Childhood Maltreatment ◽  
Teenage Pregnancy ◽  
Developmental Stages ◽  
Adverse Outcomes ◽  
Childhood And Adolescence ◽  
Negative Consequences ◽  
The Impact

A substantial body of literature suggests that childhood maltreatment is related to negative outcomes during adolescence, including delinquency, drug use, teenage pregnancy, and school failure. There has been relatively little research examining the impact that variation in the developmental stage during which the maltreatment occurs has on these relationships, however. In this paper, we reassess the impact of maltreatment on a number of adverse outcomes when developmentally specific measures of maltreatment—maltreatment that occurs only in childhood, only in adolescence, or in both childhood and adolescence—are considered. Data are drawn from the Rochester Youth Development Study, a broad-based longitudinal study of adolescent development. The analysis examines how maltreatment affects delinquency, drug use, alcohol-related problems, depressive symptoms, teen pregnancy, school dropout, and internalizing and externalizing problems during adolescence. We also examine whether the type of maltreatment experienced at various developmental stages influences the outcomes. Overall, our results suggest that adolescent and persistent maltreatment have stronger and more consistent negative consequences during adolescence than does maltreatment experienced only in childhood.

A Randomized Phase IIIB Trial of Chemotherapy, Bevacizumab, and Panitumumab Compared With Chemotherapy and Bevacizumab Alone for Metastatic Colorectal Cancer

2009 ◽  
Vol 27 (5) ◽  
pp. 672-680 ◽  
Author(s):  
J. Randolph Hecht ◽  
Edith Mitchell ◽  
Tarek Chidiac ◽  
Carroll Scroggin ◽  
Christopher Hagenstad ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Final Analysis ◽  
Skin Toxicity ◽  
Adverse Outcomes ◽  
Human Antibody ◽  
Grade 3 ◽  
And Control

Purpose Panitumumab, a fully human antibody targeting the epidermal growth factor receptor, is active in patients with metastatic colorectal cancer (mCRC). This trial evaluated panitumumab added to bevacizumab and chemotherapy (oxaliplatin- and irinotecan-based) as first-line treatment for mCRC. Patients and Methods Patients were randomly assigned within each chemotherapy cohort to bevacizumab and chemotherapy with or without panitumumab 6 mg/kg every 2 weeks. The primary end point was progression-free survival (PFS) within the oxaliplatin cohort. Tumor assessments were performed every 12 weeks and reviewed centrally. Results A total of 823 and 230 patients were randomly assigned to the oxaliplatin and irinotecan cohorts, respectively. Panitumumab was discontinued after a planned interim analysis of 812 oxaliplatin patients showed worse efficacy in the panitumumab arm. In the final analysis, median PFS was 10.0 and 11.4 months for the panitumumab and control arms, respectively (HR, 1.27; 95% CI, 1.06 to 1.52); median survival was 19.4 months and 24.5 months for the panitumumab and control arms, respectively. Grade 3/4 adverse events in the oxaliplatin cohort (panitumumab v control) included skin toxicity (36% v 1%), diarrhea (24% v 13%), infections (19% v 10%), and pulmonary embolism (6% v 4%). Increased toxicity without evidence of improved efficacy was observed in the panitumumab arm of the irinotecan cohort. KRAS analyses showed adverse outcomes for the panitumumab arm in both wild-type and mutant groups. Conclusion The addition of panitumumab to bevacizumab and oxaliplatin- or irinotecan-based chemotherapy results in increased toxicity and decreased PFS. These combinations are not recommended for the treatment of mCRC in clinical practice.

Bloodless medicine: what to do when you can't transfuse

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 553-558 ◽  
Author(s):  
Linda M.S. Resar ◽  
Steven M. Frank
Keyword(s):  
Blood Loss ◽  
Autologous Blood ◽  
Adverse Outcomes ◽  
Lessons Learned ◽  
Surgical Patients ◽  
Matched Case ◽  
New Treatment ◽  
And Control ◽  
Control Study ◽  
Better Than

Abstract A better understanding of risks associated with allogeneic blood transfusions (ABTs), along with a growing population of patients who do not accept transfusions, have led to the emergence of new treatment paradigms with “bloodless medicine.” In this chapter, we review prior studies describing management and outcomes in patients who refuse transfusion (referred to as “bloodless patients” herein) and summarize the approaches used at our institution. Bloodless management for surgical patients includes treatment of preoperative anemia, use of autologous blood salvage, and minimizing blood loss with procedures. Other adjuncts for both medical and surgical patients include minimizing blood loss from laboratory testing using pediatric phlebotomy tubes and conservative testing. Anemia can be treated with erythropoiesis-stimulating agents, as well as iron, folate, and B12 when indicated. Although there are limited retrospective studies and no prospective studies to guide management, prior reports suggest that outcomes for surgical patients managed without ABTs are comparable to historic controls. A recent risk-adjusted, propensity-matched, case-control study of outcomes of all hospitalized patients who refused ABT at a large academic health center showed that bloodless management was not an independent predictor of adverse outcomes. Surprisingly, there was a lower overall mortality in the bloodless group and discharge hemoglobin levels were similar for both bloodless and control groups. Further research is now needed to optimize therapy and identify novel interventions to manage bloodless patients. Lessons learned from bloodless patients are likely to benefit all patients given recent evidence suggesting that patients who avoid ABTs do as well, if not better, than those who accept transfusions.

scholarly journals Teenagers and Motherhood in the Cinema: «Juno», «Precious» and «The Greatest»

Comunicar ◽  
2011 ◽  
Vol 18 (36) ◽  
pp. 115-122
Author(s):  
Flora Marín-Murillo
Keyword(s):  
Young People ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Unwanted Pregnancy ◽  
Focused Attention ◽  
Direct Impact ◽  
Abortion Law ◽  
Unwanted Pregnancies ◽  
Patterns Of Behavior ◽  
Points Of View

Today in Spain there are many teenagers who suffer unwanted pregnancies. The extension of the abortion law and the approval of the sale of morning-after pill without a prescription have focused attention on girls under 18. The possibilities of motherhood, an unwanted pregnancy and the alternatives are variables that young women face in the real world, and upon which the discourses of films are constructed, some of which coincide with reality and some of which do not. On the big screen we can see movies like Juno, Precious and The Greatest which express different points of view about the topic of teenage pregnancy. These audiovisual texts have a direct impact on the creation and proliferation of models, attitudes and values. Their influence upon young people is evident and they form a reference alongside family and school for adopting certain patterns of behavior and assimilating socially accepted archetypes. This paper analyzes these films from a gender perspective, using the tools of both audiovisual language and textual analysis. Through this analysis, we establish that visions of motherhood and adolescent sex are constructed and identify the strategies used for the production of meaning in these films. The results show how the models and stereotypes survive under the appearance of renewed and alternative audiovisual discourse.En la actualidad son muchas las adolescentes en España que tienen embarazos no deseados. La ampliación de la Ley del aborto, así como la aprobación de la venta de la píldora del día después sin receta, han focalizado la atención en las jóvenes menores de 18 años. La maternidad, los embarazos no deseados y las alternativas ante estos son variables a las que las adolescentes se enfrentan en el mundo real, y sobre las cuales los filmes construyen sus propios discursos coincidentes o no con la realidad social. En las pantallas de cine películas como «Juno», «Precious» y «The Greatest» tratan bajo diferentes prismas el tema del embarazo adolescente. Estos textos audiovisuales inciden de manera directa en la reproducción y creación de modelos, actitudes y valores. Su influencia en la juventud es constatable y suponen una referencia junto con la familia y la escuela a la hora de adoptar determinados patrones de comportamiento e interiorizar arquetipos socialmente admitidos. Este trabajo examina estos filmes utilizando las herramientas tanto del lenguaje audiovisual como del análisis textual, atendiendo a una perspectiva de género. A través del análisis se constata qué visiones de la maternidad y el sexo en la adolescencia se construyen y cuáles son las estrategias de producción de sentido utilizadas. Los resultados muestran cómo los modelos y estereotipos tradicionales perviven bajo la apariencia de discursos audiovisuales renovados y alternativos.

Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes

2017 ◽  
Vol 31 (6) ◽  
Author(s):  
Yousef S. Khader ◽  
Anwar Batieha ◽  
Rana Kareem Al fursan ◽  
Rami Al-Hader ◽  
Sa’ad S. Hijazi
Keyword(s):  
Teenage Pregnancy ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
National Study ◽  
Premature Delivery ◽  
Discharge Data ◽  
Increased Risk ◽  
Maternity Hospitals ◽  
Maternal And Neonatal Outcomes

Abstract Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged <20 years were more likely to deliver prematurely compared to women aged 20–35 years [odds ratio (OR)=1.5, 95% CI: 1.2, 1.9; p < 0.005)]. However, the two groups of women did not differ significantly in low birth weight delivery (OR = 1.2, 95% CI: 0.9, 1.5; p = 0.167) and neonatal mortality (OR = 1.2, 95% CI: 0.8, 1.3; p = 0.491) in the multivariate analysis. Conclusion Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.

scholarly journals Right ventricular free-wall longitudinal speckle tracking strain as a prognostic criterion of adverse outcomes in patients with pulmonary hypertension: a systematic review and meta-analysis

2021 ◽  
Vol 26 (4) ◽  
pp. 4417
Author(s):  
E. Z. Golukhova ◽  
I. V. Slivneva ◽  
M. L. Mamalyga ◽  
D. I. Marapov ◽  
M. N. Alekhin ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Predictive Value ◽  
Speckle Tracking ◽  
Meta Analysis ◽  
Composite Endpoint ◽  
Adverse Outcomes ◽  
Control Group ◽  
Right Ventricular Free Wall ◽  
The Mean ◽  
And Control

The absence of consensus regarding the reference values of right ventricular free wall longitudinal strain (RVFWLS) and its predictive value prompted us to conduct a systematic review and meta-analysis of publications on the predictive role of this parameter in patients with pulmonary hypertension (PH).Aim. To study the independent predictive value of RVFWLS in PH patients using 2D/3D speckle tracking echocardiography.Material and methods. Firstly, 317 publications (PubMed) and 857 Google Scholar results were selected. Of the initially identified search results, 12 articles were analyzed. The papers were cohort designed.Results. The total number of patients with PH was 1281. The mean age of patients was 54,7±6,8 years. Four studies compared the RVFWLS with a control group (n=251). The mean RVFWLS were -17,0±2,4% and -24,7±2,2% in the experimental and control groups, respectively. A meta-analysis of the difference between the mean RVFWLS values in experimental and control group patients showed its total increase in PH subjects of 8,06% (95% CI: 5,18-10,94%; p<0,00001).The total number of deaths was 268 (all-cause — 180, composite endpoint — 88). According to the meta-analysis, with an increase of 1% in RVFWLS, there is an increase in mean all-cause mortality risk by 14% (p<0,00001), as well as mean risk of adverse outcomes or PH-related events (composite endpoint) by 14% (p<0,0001).Conclusion. These results highlight the high independent predictive value of RVFWLS as a predictor of adverse outcomes or events associated with a right ventricular dysfunction progression in PH patients.

scholarly journals Obstetric Outcome of Teenage Pregnancy

2014 ◽  
Vol 7 (2) ◽  
pp. 29-32
Author(s):  
S Kayastha ◽  
A Pradhan
Keyword(s):  
Pregnant Woman ◽  
Birth Weight ◽  
Teenage Pregnancy ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Test Group ◽  
Control Group ◽  
Obstetric Outcome ◽  
Normal Delivery ◽  
And Control

Aims: To assess the prevalence of teenage pregnancies and to compare the obstetric performance of teenage pregnant woman with that of adult pregnant woman. Methods: A prospective study was conducted in Nepal Medical College Teaching Hospital from August, 2010 to February, 2012 (one and half year duration). All the teenage pregnancies were included and outcomes were compared with adult (20-24 years) pregnancies, selected randomly who had delivered during the same period of time. The patient characteristics (age, gravidity, parity, gestation age) and obstetric outcome (medical and obstetrical complications, mode of delivery, complications during delivery, fetal outcome, birth weight) were compared between the two groups. Statistical analysis was preformed using PHSTATZ and Z test for proportion. Results: There were total 2708 deliveries during the study period, out of which teenage pregnancy was 264 (9.7%). There were 69(26.1%0) teenage mothers of age 16 to 17 years and 195(73.9%) of age group 18 to 19 years. As expected, maximum patients in the test group i.e. teenagers were primigravida as compared to control group. (90.1% vs. 68.5%). As for mode of delivery, normal delivery in test and control was 82.9% vs 81.1% (p=0.56) and rate of cesarean delivery was similar 10.2% and 10.7%, (p=0.84) in both the groups. The incidence of instrumental delivery was more in control group although it was not statistically significant( 0.7% vs 2.2%, p=0.16). Preterm delivery was 3.0% in teenage as compared to control which is 2.2%. The percentage of intrauterine fetal death was 0.7% vs 0% in test and control group (p=0.15). Proportion of low birth weight babies in test and control group was 7.2% vs 5.9% (p=0.55). Similarly pregnancy related complications were also compared in teenage and control groups. It was found that postpartum hemorrhage occurred more in teenage pregnancy 1.8% vs 0.7% (p=0.84) but statistically not significant. Incidence of hypertensive disorders was 6.4% and 5.6% (p=0.66) in test and control group. Proportion of babies with intrauterine growth restriction was 3.0% in test and 1.1% (p=0.009) in control, the only parameter that is statistically significant. Fetal congenital anomaly was 0.7% vs 0.4% (p=0.54) Conclusions: Teenage pregnancy can have an equally good outcome if we give good obstetric care and encourage institutional delivery. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11139 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 29-32

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